Transgastric Ultra-Slim Endoscopic Tunneling NOTES for Gallbladder Preservation: Comparative Study With Conventional...

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Surgery

Background:

• Gallbladder-preserving treatment for gallstones and polyps is an evolving area.
• Natural orifice transluminal endoscopic surgery (NOTES) offers a less invasive approach.
• Comparing different NOTES techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare clinical outcomes of ultrathin tunneling NOTES versus conventional NOTES.
• To evaluate the efficacy and safety of these gallbladder-preserving endoscopic techniques.
• To assess the impact of ultrathin tunneling on surgical trauma and patient recovery.

Main Methods:

• Retrospective study of 62 patients (January 2023 - February 2025).
• Comparison between ultrathin tunneling NOTES (n=23) and conventional NOTES (n=39).
• Evaluation of clinical outcomes, operative parameters, pain, recovery time, costs, and complications.

Main Results:

• Both techniques achieved 100% clinical success.
• Ultrathin tunneling group had significantly less blood loss, fewer clips, lower pain scores, and shorter hospital stays (P<0.05).
• No significant differences in operative time, flatus time, costs, or recurrence rates were observed (P>0.05).

Conclusions:

• Both NOTES techniques are safe and effective for gallbladder-preserving gallstone and polyp treatment.
• Ultrathin tunneling NOTES demonstrates advantages in reducing surgical trauma and improving recovery.
• The ultrathin tunneling approach shows potential for lowering recurrence risk and warrants clinical application.