Natural orifice surgery: initial clinical experience

被引:132
|
作者
Horgan, Santiago [1 ]
Cullen, John P. [1 ]
Talamini, Mark A. [1 ]
Mintz, Yoav [1 ]
Ferreres, Alberto [2 ]
Jacobsen, Garth R. [1 ]
Sandler, Bryan [1 ]
Bosia, Julie [1 ]
Savides, Thomas [3 ]
Easter, David W. [1 ]
Savu, Michelle K. [1 ]
Ramamoorthy, Sonia L. [1 ]
Whitcomb, Emily [4 ]
Agarwal, Sanjay [4 ]
Lukacz, Emily [4 ]
Dominguez, Guillermo [2 ]
Ferraina, Pedro [2 ]
机构
[1] Univ Calif San Diego, Dept Surg, San Diego, CA 92103 USA
[2] Buenos Aires Hosp Clin, Dept Gen Surg, Buenos Aires, DF, Argentina
[3] Univ Calif San Diego, Dept Gastroenterol, San Diego, CA 92103 USA
[4] Univ Calif San Diego, Dept Reprod Med, San Diego, CA 92103 USA
关键词
Appendix; Cholecystectomy; Clinical papers; trials; research; Endoscopy; Surgical; TRANSLUMINAL ENDOSCOPIC SURGERY; ASSISTED VAGINAL HYSTERECTOMY; LAPAROSCOPIC HYSTERECTOMY; CHOLECYSTECTOMY; PERITONEOSCOPY; PATIENT;
D O I
10.1007/s00464-009-0428-0
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Natural orifice translumenal endoscopic surgery (NOTES) has moved quickly from preclinical investigation to clinical implementation. However, several major technical problems limit clinical NOTES including safe access, retraction and dissection of the gallbladder, and clipping of key structures. This study aimed to identify challenges and develop solutions for NOTES during the initial clinical experience. Methods Under an Institutional Review Board (IRB)-approved protocol, patients consented to a natural orifice operation for removal of either the gallbladder or the appendix via either the vagina or the stomach using a single umbilical trocar for safety and assistance. Results Nine transvaginal cholecystectomies, one transgastric appendectomy, and one transvaginal appendectomy have been completed to date. All but one patient were discharged on postoperative day 1 as per protocol. No complications occurred. Conclusion The limited initial evidence from this study demonstrates that NOTES is feasible and safe. The addition of an umbilical trocar is a bridge allowing safe performance of NOTES procedures until better instruments become available. The addition of a flexible long grasper through the vagina and a flexible operating platform through the stomach has enabled the performance of NOTES in a safe and easily reproducible manner. The use of a uterine manipulator has facilitated visualization of the cul de sac in women with a uterus to allow for safe transvaginal access.
引用
收藏
页码:1512 / 1518
页数:7
相关论文
共 50 条
  • [21] Embryonic Natural Orifice Transumbilical Endoscopic Surgery (E-NOTES) for Advanced Reconstruction: Initial Experience Comment
    Assimos, Dean
    JOURNAL OF UROLOGY, 2009, 181 (03): : 1211 - 1211
  • [22] Natural orifice transluminal endoscopic surgery (NOTES): initial experimental results
    Olsina Kissler, Jorge Juan
    Balsells Valls, Joaquin
    Dot Bach, Juan
    Abu Suboh Abadia, Monder
    Armengol Bertroli, Jordi
    Esteves, Marielle
    Rosal Fontana, Marta
    Ramon Armengol-Miro, Jose
    CIRUGIA ESPANOLA, 2009, 85 (05): : 298 - 306
  • [23] Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience
    Zou, Xiaofeng
    Zhang, Guoxi
    Xiao, Rihai
    Yuan, Yuanhu
    Wu, Gengqing
    Wang, Xiaoning
    Long, Dazhi
    Wu, Yuting
    Liu, Min
    Xue, Yijun
    Zhang, Xu
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2011, 25 (12): : 3767 - 3772
  • [24] Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience
    Xiaofeng Zou
    Guoxi Zhang
    Rihai Xiao
    Yuanhu Yuan
    Gengqing Wu
    Xiaoning Wang
    Dazhi Long
    Yuting Wu
    Min Liu
    Yijun Xue
    Xu Zhang
    Surgical Endoscopy, 2011, 25 : 3767 - 3772
  • [25] Pure natural orifice transluminal endoscopic surgery resection of a huge peritoneal cyst: First clinical experience
    Liu, Dan
    Tu, Qiuyue
    Liu, Bingrong
    DIGESTIVE ENDOSCOPY, 2022, 34 (06) : E132 - E133
  • [26] EUS in localizing safe alternate access sites for natural orifice transluminal endoscopic surgery: initial experience in a porcine model
    Elmunzer, B. Joseph
    Schornisch, Steve J.
    Trunzo, Joseph A.
    Poulose, Benjamin K.
    Delaney, Conor R.
    McGee, Michael F.
    Faulx, Ashley L.
    Marks, Jeffrey M.
    Ponsky, Jeffrey L.
    Chak, Atnitabh
    GASTROINTESTINAL ENDOSCOPY, 2009, 69 (01) : 108 - 114
  • [27] EUS in localizing safe alternate access sites for natural orifice transluminal endoscopic surgery: initial experience in a porcine model
    Prat, F.
    Elmunzer, B. J.
    Schonmisch, S. J.
    Trunzo, J. A.
    Poulose, B. K.
    Delaney, C. P.
    McGee, M. F.
    ACTA ENDOSCOPICA, 2009, 39 (02) : 113 - 113
  • [28] Natural orifice translumenal endoscopic surgery applications in clinical practice
    Coomber, Ross S.
    Sodergren, Mikael H.
    Clark, James
    Teare, Julian
    Yang, Guang-Zhong
    Darzi, Ara
    WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY, 2012, 4 (03): : 65 - 74
  • [29] Natural orifice surgery in thoracic surgery
    Liu, Yun-Hen
    Chu, Yen
    Wu, Yi-Cheng
    Yeh, Chi-Ju
    Liu, Chien-Ying
    Hsieh, Ming-Ju
    Yuan, Hsu-Chia
    Ko, Po-Jen
    Liu, Hui-Ping
    JOURNAL OF THORACIC DISEASE, 2014, 6 (01) : 61 - 63
  • [30] The natural orifice surgery edition
    G. Spaun
    European Surgery, 2011, 43 : 127 - 129