Women’s Perceptions of Trans-Vaginal NOTES Surgery
Two decades ago, Minimally Invasive Surgery (MIS) was introduced and led to a revolution in modern surgery; currently MIS procedures are the standard of care for many surgical interventions and patients often seek out surgeons with special training in MIS. Today, Natural Orifice Translumenal Endoscopic Surgery (NOTES) appears to be on the threshold of another… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
What Is the Ideal Location and Size of a Gastrotomy?
BACKGROUND:The feasibility of using the endoscopic transgastric approach to perform an intra-abdominal surgical procedure has been well demonstrated in animal models. Factors that could possibly limit the successful closure of a gastrotomy include: (a). its anatomical location on the gastric surface; (b). its diameter size, and, (c). duration of the transgastric procedure. Our hypothesis is… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Use of Endoluminal Therapies for Obese Patients with GERD
Introduction: Body mass index > 30 is a preoperative predictor of failure after antireflux surgery, limiting therapeutic options for obese patients with medically refractory GERD. This study seeks to evaluate outcomes after two different endoluminal GERD therapies for these patients.Methods: Obese patients (BMI>30) presenting with medically-refractory GERD underwent either a single endoscopic full thickness (EFT)… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Two layer closure of gastrotomy following transvaginal and transgastric peritoneoscopy in an animal model
BackgroundNatural orifice translumenal endoscopic surgery (NOTES) is a newly developing technology in the surgical field. Methods of gastrotomy closure are still far from satisfactory and pose a major hindrance to the development of NOTES. A new concept of transvaginal and transgastric peritoneoscopy followed by a two-layer endoclip closure of gastrotomy wound is presented.MethodsFour pigs were… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Transgastric Peritoneoscopy for Evaluation of the Abdominal Wall to Direct Laparoscopic Trocar Placement
Objective: Access to the peritoneal cavity to direct therapy is one of the initial steps in the evaluation of NOTES. We hypothesize the peritoneal cavity can be safely entered transgastrically without laparoscopic guidance to visualize the abdominal wall and guide laparoscopic port placement in morbidly obese patients undergoing Roux-en-y gastric bypass (RYGB) surgery.Methods: Abdominal trocar… Continue Reading
- Type:
- Posters
- 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
Transanal endoscopic microsurgery (T.E.M) treatment of rectal cancer: A comparision of outcomes with and without neoadjuvant radiation therapy
Introduction: Improved tumor downstaging and complete response rates of rectal cancer treated with neoadjuvant therapy have been observed. There has been concern that the detrimental, local effect of radiation makes this approach unsuitable for excision. We compared 2 groups of patients undergoing comparable TEM surgery, with and without neoadjuvant radiation. Methods: All patients undergoing TEM… 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
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
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
Toward Natural Orifice Surgery with Cooperative Miniature Robots
Introduction: While Natural Orifice Translumenal Endoscopic Surgery (NOTES) is very appealing from the patient’s perspective, it is surgically challenging by its very nature because access is limited to the size of the natural orifice. It is difficult to have multiple instruments simultaneously passing through an orifice, and the instruments must be flexible throughout their entirety… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
The Impact of Proton Pump Inhibitors on Intra-peritoneal Sepsis:
Study Aim: Proton pump inhibitors (PPI) are commonly given for the treatment of GERD and ulcer disease. In many non-operative cases of perforated ulcer disease, it is standard of care. During transgastric NOTES procedures there is an iatrogenic perforation of the gastric wall with leakage of gastric contents into the peritoneal cavity. Our study aim… 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
Suture Survival in an Acidic Environment: Implications for Natural Orifice Transgastric Endolumenal Surgery (NOTES)
Background: Recent interest in translumenal approaches to conventional surgical procedures such as NOTES has reintroduced the question of what is the ideal suture material for visceral closure of enterotomy sites. With necessity of secure closure from transgastric approaches, a study was designed to test the hypothesis that there would be variable longevity of suture ligature… 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