A Computer-Assisted Endoscope to facilitate access and support surgical tasks in the abdomen: Animal experience
Objective: Natural orifice transluminal endoscopic surgery has potential benefits for patients and clinicians. Many improved tools have been developed in the last few years, but access, navigation and orientation, especially in the upper abdomen for procedures such as diaphragmatic pacing and Nissen fundoplication, remain an unsolved challenge. NeoGuide has developed a computer-controlled multi-segmented endoscope with… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
A Hybrid Endoluminal Transgastric Cholecystectomy Approach – a Bridge Between Laparoscopy and NOTES
Background: The Natural Orifice Transgastric Cholecystectomy is a method in development. This study proposes the hybrid approach, transluminal and laparoscopic, showing the advantages of the technique.Methods: Non-survival procedures were conducted in pigs(n=15) using a transgastric approach. The procedure started with a puncture in the umbilical scar to create a CO2 pneumoperitoneum through the Veress needle.… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
A safe and easy method of gastrotomy creation and closure for NOTES
Introduction:As a foundation for transgastric NOTES, we aimed to develop an easy and fast method to create and close a gastrotomy without the use of endoluminal suturing devices.Methods:Four pigs, mean weight 36 kg, were used for this survival study. Pigs were anesthetized and received preoperative IV antibiotics. The stomach was endoscopically irrigated with saline, followed… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
An Endosurgical Operating System: Initial Human Experience in Endolumenal and NOTES Procedures
Background: Minimally invasive surgery is rapidly evolving with the promise of new endolumenal and translumenal surgical procedures performed with few or no external incisions. We describe our early human experience with a flexible platform technology that provides stable access and visualization, force transmission, two-handed tissue manipulation and durable tissue approximation. The EndoSurgical Operating System (EOS),… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Assessment and COMPARISON OF digital image quality for peritoneoscopy USING THE flexible endoscope AND the rigid LAPAROSCOPE FOR NOTES PROCEDURES
Introduction: Although NOTES peritoneoscopy has been widely performed, the image quality acquired with flexible endoscopes has never been directly compared with the current gold standard of the rigid laparoscope. The purpose of the current study was to assess and compare the image quality derived from the flexible endoscope versus the rigid laparoscope during exploratory peritoneoscopy.… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Bird’s-Eye View: A Visual Adjunct for Spatial Orientation Improves Efficacy of NOTES Procedures
Introduction: Although NOTES research has shown substantial progress in recent years, some technical challenges remain. Among them is the suboptimal spatial orientation of the flexible endoscope within the peritoneal cavity. Due to the endoscope’s lack of rigidity, the ability to retroflex, and, more importantly, the coupling of the image source to the end effector instruments,… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Burst Pressures in Gastric Closure – a NOTES Comparison Study of Looped T-Anchors vs. Endoclips in the Explanted Porcine Stomach
Background: A reliable, secure closure of the gastrotomy remains a fundamental challenge in transgastric NOTES procedures. Gastrotomy closure using endoscopic clips is unreliable, technically difficult, and expensive. Few tests of the integrity of these closures have been published. We compared burst pressures in gastric explants utilizing looped T-anchors and endoscopic clips.Methods: In nine explanted porcine… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Colonic Sterilization for NOTES Procedures – a Comparison of Two Decontamination Protocols
Introduction:In the 2005 White Paper, prevention of infection was named as one of the ten potential barriers to performing NOTES surgery. The aim of this study was to evaluate the effect of two different sterilization protocols on the bacterial counts in the swine colon while preparing for NOTES surgery.Methods:After placing a proximal colon balloon, 16… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Direct Comparison of Different Techniques of Transgastric Access for NOTES Procedure
INTRODUCTION: Safe access to the peritoneal cavity is paramount for success of the NOTES procedures. We have recently described a PEG-like approach and pneumoperitoneum-assisted translumenal access to the peritoneal cavity. Aim of the study: Direct comparison of different transgastric access techniques in a live porcine model. METHODS: Fifteen experiments were performed on 50-kg pigs (Sus… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Directed Submucosal Tunneling for Transgastric NOTES Procedures
Background: Prior natural orifice translumenal endoscopic surgery (NOTES) work has shown the feasibility and the advantages of obtaining peritoneal access by using a tunneled translumenal approach. Objective: We evaluated the feasibility of creating directed transgastric submucosal tunnels with the goal of positioning the endoscope in an in-line position with target abdominal locations. Methods: We obtained… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Durability of a Novel Full Thickness Percutanous Endoscopic Sleeve Gastroplasty (pesg): Survival Study
Background: Percutaneous endoscopic sleeve gastroplasty (PESG) may have a role as a restrictive weight loss procedure. We hypothesize that we can safely perform a durable PESG using full thickness endoluminal plications. Methods: After developing the PESG on ex-vivo porcine stomachs and 6 non-survival procedures, we tested the durability by performing 6 survival procedures on 30… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Durability of an Endoscopic Endolumenal Gastric Plication
Objectives: The goal of our study was to determine the safety and durability of an endolumenal plication of the stomach. Methods and Procedures: Ten 25-kg female swine underwent standard upper endoscopy, during which a single, 12 mm intragastric laparoscopic trocar was placed. Using the EndoStitch device (U.S. Surgical), an 8cm gastric sleeve was created by… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Early Experience with Transgastric NOTES Cholecystectomy in Humans
Natural orifice transluminal endoscopic surgery has enjoyed an accelerated development, going from theory to clinical application in less than 4 years. Early concepts of NOTES procedures seldom included cholecystectomy as it was considered too complex and challenging to approach with current technology. An unprecedented evolution of flexible endoscopes and endoscopic tools changed this and currently… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Early Post Procedure Fever After Radiofrequency Ablation of Barrett’s Esophagus Using the Halo® Procedure.
Introduction: Barrett’s esophagus, or intestinal metaplasia of the esophagus, is a premalignant condition related to Gastro-Esophageal Reflux Disease. The presence of Barrett’s Esophagus leads to an increased risk of development of esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma is increasing, while its cure rate has changed little in recent years. The Halo® procedure is an… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Endolumenal Anastomosis Creation with Magnets
Objective: Creation of a safe endolumenal gastro-jejunal anastomosis with neodymium magnets.Background: This paper describes a new technique for performing an endolumenal gastro-jejunal anastomosis using neodymium magnets.Methods: An experimental survival study was conducted in seven swine with open translumenal placement of variable shaped magnets in the stomach and jejunum. An anastomosis was created between magnets in… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES