当前位置： SCI文献检索 > GASTROINTESTINAL ENDOSCOPY期刊下所有文献 > Self-approximating transluminal access technique for natural orifice transluminal endoscopic surgery: a porcine survival study (with video).

Self-approximating transluminal access technique for natural orifice transluminal endoscopic surgery: a porcine survival study (with video).

Abstract：

BACKGROUND:The ability to access the abdominal cavity though a direct (modified-PEG type) gastric incision to perform natural orifice transluminal endoscopic surgery (NOTES) has been demonstrated in the literature. However, the optimal technique to access the abdomen remains unknown. OBJECTIVE:The aim of this study was to evaluate the safety and feasibility of a transgastric approach to the abdominal cavity through an extended submucosal tunnel. DESIGN:Animal feasibility study. INTERVENTIONS:Transgastric endoscopic peritoneoscopy was performed in 7 anesthetized swine, including 2 acute and 5 survival animals. After the creation of a 10-cm to 12-cm tunnel in the gastric submucosal plane, the peritoneal cavity was accessed by needle-knife puncture through the gastric wall near the greater curvature. The peritoneal cavity was examined before the gastric mucosal incision was closed with endoclips. Survival animals were euthanized two weeks after the procedure, and a necropsy was performed. RESULTS:The abdominal cavity was successfully entered without complication in all 7 animals. The mucosal incisions were able to be closed by endoscopy. In the survival experiments, all animals recovered and gained weight. Two animals experienced clinically unapparent infectious complications. LIMITATIONS:Small sample size. CONCLUSIONS:A peroral transgastric approach to the abdominal cavity through an extended submucosal tunnel is technically feasible and allows safe abdominal access and reliable closure with currently available technology. It has potential benefits as an alternative to direct transgastric access for NOTES procedures.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Pauli EM,Moyer MT,Haluck RS,Mathew A

doi

10.1016/j.gie.2007.09.023

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

690-7

issue

4

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(07)02687-9

journal_volume

67

pub_type

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