• Skip to primary navigation
  • Skip to main content

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • Leadership
    • SAGES Mission Statement
    • Advocacy
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call For Abstracts
      • 2026 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES Video Subscription
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Free Webinars For Residents
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Fluorescence-Guided Surgery Course for Fellows
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Recognition Opportunities
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS / FLS
  • Log In

Hybrid Transvaginal NOTES Sleeve Gastrectomy in a Pocine Model Using a Magnetically Anchored Camera and Novel Instrumentation

Introduction: The purpose of this study was to determine the feasibility of transvaginal NOTES sleeve gastrectomy using novel instrumentation in a porcine model.
Methods: Anesthetized pigs (non-survival (n=7), 14-day survival (n=1)) underwent sleeve gastrectomy procedures. Under endoscopic visualization, a 25mm x 40cm access port was inserted through a vaginotomy into the peritoneal cavity using blunt dissection (n=5) or a rigid optical obturator (n=3). A Magnetic Anchoring and Guidance System (MAGS) video camera was deployed intra-abdominally and used for subsequent visualization. A long 5mm rigid grasper inserted transvaginally outside of the access port and a 3 mm laparoscopic grasper inserted through a transabdominal left flank trocar were used for tissue manipulation. Percutaneous T-tags were placed at the gastric fundus for retraction. A transorally placed gastroscope was used for gastric tube calibration. Prototype long (61-82cm) transvaginal staplers were used for stomach and vascular division. Alternatively, an endoscopic bipolar sealing device was used for vascular division (n=3). Values are mean ± s.d.
Results: Operative time was 169 ± 46 minutes and blood loss was 156 ± 109 cc. The entire procedure was completed in 4 of 8 cases. Incomplete procedures were due to stapler malfunction (3 cases) and esophageal transection (1 case). Gastric division was completed in 5 of 8 cases; in 4 cases, acceptable tube geometry and volume (165 ± 34 cc) were achieved with no staple line leaks detected in 3 cases. Stapled short gastric vascular division was completed in 7 of 8 cases; bipolar vascular sealing was ineffective in 3 of 3 attempted cases. The MAGS camera was used for 100% of the procedure in 8 of 8 cases but required flexible endoscopic assistance for illumination in 2 cases when the onboard LED’s failed; significant fogging was encountered in 2 cases. At autopsy, there were 2 rectal injuries due to instrument insertion outside of the access port, 1 bladder injury due to optical obturator insertion, and 1 splenic vessel injury due to T-tag penetration. The survival animal thrived post-operatively and had no complications.
Discussion: Transvaginal sleeve gastrectomy appears to be feasible in a porcine model but complications may occur when instruments are inserted without appropriate visualization or protection within a transvaginal access port. Additional device development may yield improved outcomes.


Session: Poster

Program Number: P280

61

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon

Related



  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2025 Society of American Gastrointestinal and Endoscopic Surgeons