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
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
Gastric Pouch and Stoma Reduction Using a Novel Endoscopic Device: The Endosurgical Operating System (eos)
GASTRIC POUCH AND STOMA REDUCTION USING A NOVEL ENDOSCOPIC DEVICE: THE ENDOSURGICAL OPERATING SYSTEM (EOS) DK Mullady1, D Herron2, D Lautz1, D Birkett3, and CC Thompson11Division of GastroenterologyBrigham and Women’s Hospital, Boston, MA2Mount Sinai Hospital, New York, NY3Lahey Clinic, Burlington, MA Introduction: Roux-en-Y gastric bypass is an effective treatment for severe obesity. However, many patients… Continue Reading
- Topic:
- Endolumenal / NOTES
Feasibility of Endoscopic Transgastric (ETGN) and Transvaginal (ETVN) Nephrectomy in the Porcine Animal Model.
BACKGROUND: Prior studies demonstrate the feasibility of NOTES organ resection. Aim of this study was to develop an endoscopic minimally-invasive resection of the kidney. METHODS: Using an endoscopic transgastric (N=2) and transvaginal (N=4) approach, resection of the kidney was performed in the porcine animal model. RESULTS: Six female swine underwent endoscopy with a double-channel gastroscope.… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Endoscopic Endoluminal Radiofrequency Ablation of Barrett\’s Esophagus: Initial Results and Lessons Learned
Background: Ablating Barrett’s epithelium may reduce the risk of developing esophageal adenocarcinoma. This study reports the initial experience of a single surgeon using an endoscopic endoluminal device delivering radiofrequency energy (the BARRx device) in ablating Barrett’s esophagus.Methods: All patients who underwent ablation of Barrett’s epithelium with the BARRx system were reviewed for length of Barrett’s… Continue Reading
- Type:
- Podium Presentations
- 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
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
Omentoplasty for Gastrotomy Closure After NOTES Procedures
Introduction: The antibacterial and healing properties of the greater omentum have yet to be used in translumenal access closure of NOTES procedures. Objective: To evaluate the feasibility, efficacy and tolerance of the incorporation of a flap of greater omentum in gastrotomy closure sites. Methods and procedures: Survival experiments were performed in nine 40-kg pigs under… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
NOTES Ovariectomy in Dogs–A Feasibility Study
NOTES procedures were performed in 5 dogs by creating access to the abdominal cavity via the stomach using a flexible endoscope and guide wire, needle knife electrode, and balloon dilation catheter. Following inflation with air, an electrocautery snare was used to coagulate and cut tissue to remove the ovaries. The ovaries were then extracted, visually… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Rigid Transvaginal Retraction in Hybrid NOTES Cholecystectomy
Introduction: As techniques of natural orifice translumenal endoscopic surgery (NOTES) improve, the safe performance of totally translumenal surgery is becoming more feasible. In a previous report of a hybrid approach to natural orifice transvaginal cholecsytectomy we noted difficulty with gallbladder retraction and could only accomplish this transabdominally.We present a novel technique and instrument that allows… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Gastrotomies Do Not Require Repair Following Transgastric Instrumentation: A Controlled Study
Introduction: The optimal method for closing gastrotomies following transgastric instrumentation has yet to be found. Our center has previously validated the use of a bioabsorbable plug for this purpose. The goal of this study was to compare gastrotomy closure, in a canine model, between animals left to heal without treatment and those treated with endoscopically… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
NOTES sigmoid resection
Bakground:NOTES Colonic resection is difficult to perform because of the need for exposure, dissection, vascular control and anastomosis. The aim of the present study was to evaluate the feasibility and early results of combined transgastric-transrectal NOTES sigmoidectomy.Materials and Methods:A two-week survival study was undertaken to evaluate the combined trangastric-transrectal approach for sigmoidectomy in 5 mini-pigs.… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
First experience of human NOTES in Ukraine: Transvaginal and transumbilical rendezvous cholecystectomy
Introduction. The biggest problem for safeness of NOTES is the great possibility of contamination spreading from natural orifice into the peritoneal cavity. Currently transvaginal approach seems to be the simplest in access and wound closure. Thus, the aim of our study was evaluation of peritoneal contamination and adhesions formation after transvaginal and transumbilical rendezvous approach… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
NOTES: new concepts in gastric closure
Introduction:Closure of the gastrotomy, when performing transgastric procedures, is one of the most challenging steps. Several methods of gastric closure have been described in the literature but to date there is still a lack of a rapid, simple and effective device. The aim of this study was to evaluate the technical feasibility, efficacy and safety… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
NOTES Transvaginal Hernia Repair with Alloderm Mesh
Introduction: Natural Orifice Translumenal Endoscopic Surgery (NOTES) is a new technique for completing operations by using the body’s natural orifices. Patients with abdominal wall hernias are one subset of patients that may benefit from NOTES therapy as standard surgical techniques may create more hernias for these patients. Methods: Two 35 kg pigs underwent a ventral… Continue Reading
- Topic:
- Endolumenal / NOTES