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
Laparoscopic- Assisted Endoluminal Surgery: a Steping Stone to NOTES
Background:As Natural Orifice Transluminal Endoscopic Surgery (NOTES) approaches on the horizon, surgeons will need to develop the fundamental skills and spatial orientation needed to perform in this new perspective. The Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) has established several fundamental challenges to the safe introduction of NOTES. Our institutional experience with laparoscopic… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Trans-esophageal Cardiomyotomy Utilizing Submucosal Dissection: An Acute Porcine Procedure
Background: Previous investigators have demonstrated the ability to perform an esophageal myotomy via a natural orifice translumenal endoscopic surgery (NOTES) approach. To date, no one has performed a NOTES myotomy including both gastric and esophageal musculature.Objective: Our objective was to perform a complete cardiomyotomy via a trans-esophageal route using the self-approximating translumenal access technique (STAT).Methods:… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Full thickness excision of T1 rectal cancer with transanal endoscopic microsurgery
Background: Transanal endoscopic microsurgery is a useful method for the local excision of polyps and selected rectal cancers. The standardization of the technique for this procedure is likely to be important for preventing local recurrence. This video demonstrates the standard procedure of TEM in a patient with a 5cm rectal polyp. Methods: The patient was… Continue Reading
- Type:
- Podium Presentations
- 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
Trans Oral Endoscopic Stapled Esophago Diverticulostomy (toesed ) for Zenker’s Diverticulum
Introduction: Zenker's diverticulum is a known cause for dysphagia and is treated usually by resection or diverticulopexy through a neck incision. In recent years an endoscopic per-oral method has been described. A cohort of patients was treated and long-term follow up was obtained.Materials and Methods: All patients presented with the diagnosis of Zenker's diverticulum were… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Transgastric Endoscopic Peritoneoscopy Does Not Require Decontamination of the Stomach in Humans
Introduction: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a rapidly evolving field that provides endoscopic access to the peritoneum via a natural orifice. One important requirement of this technique is the need to minimize the risk of clinically significant peritoneal contamination. We report the bacterial load and contamination of the peritoneal cavity in patients undergoing… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Natural Orifice Cholecystectomy Using a Miniature Robot
Introduction: Natural Orifice Translumenal Endoscopic Surgery (NOTES) is surgically challenging. Current endoscopic tools provide an insufficient platform for visualization and manipulation. This study demonstrates the feasibility of using a miniature in vivo robot to enhance visualization and provide off-axis dexterous manipulation capabilities for NOTES. Methods: We developed a dexterous, miniature robot with six degrees-of-freedom capable… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Open label, prospective, randomized controlled trial of endoscopic duodenal jejunal bypass sleeve versus low calorie diet for weight loss.
Background: The duodenal jejunal bypass sleeve (DJBS) has been shown to achieve a completely endoscopic duodenal exclusion without the need for stapling or anastomosis. This report consists of the first randomized controlled trial for weight loss. Methods: In a 12-week, open label, prospective, randomized study, patients received either a low fat diet and the DJBS… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
The First Human Abdominal Surgery in Prone Position: An Example of How NOTES Can Be Used to Perform Unique Procedures
NOTES has been touted as the next step in minimally invasive surgery. As such, most of the effort to perform NOTES has been focused on reproducing surgical procedures in a manner similar to how they are accomplished laparoscopically. It seems, however, that a potential advantage for NOTES is to allow surgeons to perform operations in… Continue Reading
- Type:
- Podium Presentations
- 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
Human Transvaginal Cholecystectomy using an IT-Knife
Background: NOTES is an evolving and controversial field of surgery on its beginning. Laparoscopic surgery and Endoscopy merges to fulfill it. Despite NOTES human experience had begin by the transgastric way with Rao in India, the transvaginal approach is taking place as a safer and easy way to achieve the upper abdomen. As on its… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Trangastric access to the chest: opening a new vista?
Introduction:The NOTES approach to the peritoneal cavity is well established today and procedures in humans have already been performed. The next question to be addressed is whether this access can be extended further. This video shows the feasibility of feasibility of transgastric access to the thoracic cavity in the porcine model.Materials and methods:A series of… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES: Transvaginal Cholecystectomy with Assisting Articulating Instruments
Introduction: Transvaginal cholecystectomy has been performed at several institutions using the hybrid NOTES techniques. Methods: The patient is a 42 year old female with symptomatic cholelithiasis. After obtaining informed consent, the patient was taken to the operating room for transvaginal cholecystectomy. A single 5 mm laparoscope was placed at the umbilicus, followed by a 15mm… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Magnetic Retraction for NOTES Transvaginal Cholecystectomy
Introduction: Natural orifice surgery (NOTES) has the potential to decrease the burden of an operation on a patient. Limitations of the endoscopic platform require innovative solutions to provide retraction and create an operation comparable to the gold standard, laparoscopic cholecystectomy. Methods: Four patients underwent transvaginal cholecystectomy. All procedures were performed under laparoscopic vision to ensure… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES