New Technique for Gastrotomy Closure in NOTES and its Comparison with Endoclips
INTRODUCTION: Numerous experimental studies have been conducted to evaluate, explore, and develop Natural Orifice Transluminal Endoscopic Surgery (NOTES). The results have been varied ranging from mediocre to excellent. The most common challenge and perhaps the main limiting factor for the progress of NOTES has been the issue of adequate and effective gastrotomy closure. We describe… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Natural Orifice Translumenal Endoscopic Drainage for Pancreatic Abscesses
INTRODUCTION: Endoscopic pseudocyst drainage is well documented, but few series describe endoscopic drainage of pancreatic abscesses. Abscesses are complications of pancreatitis, presenting with sepsis and/or peritonitis. We report the feasibility and efficacy of natural orifice translumenal endoscopic surgery for pancreatic abscesses. METHODS: We reviewed consecutively treated patients (1994-2007). Approaches alone or in combination were: (1)… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES: Cadaveric Rendezvous Hybrid Small Bowel Resection
Natural Orifice Translumenal Endoscopic Surgery (NOTES) is an emerging field in minimally invasive surgery that is driving the development of new technology and techniques. Before NOTES gains widespread popularity, it must be proven to be a safe and efficacious technique. There are several proposed benefits of the NOTES approach. Among these benefits are a potentially… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Natural Orifice Translumenal Endoscopic Surgery with a Miniature in Vivo Surgical Robot
Introduction: The application of flexible endoscopy tools for Natural Orifice Translumenal Endoscopic Surgery (NOTES) is constrained due to limitations in dexterity, instrument insertion, navigation, visualization, and retraction. Miniature endolumenal robots that are not constrained by the natural orifice can mitigate these constraints through providing a stable platform for visualization and dexterous manipulation. This video demonstrates… Continue Reading
- Type:
- Podium Presentations
- 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
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
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
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
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
Histological Aspects of the Healing of a Gastrotomy in Different Gastric Regions.
BACKGROUND. The endoscopic transgastric technique is increasingly gaining popularity among surgeons and gastroenterologists. Factors that could potentially limit the use of the gastric lumen to endoscopically access the intra-abdominal cavity have not been fully investigated. The gastric chamber is a complex organ, physiologically and anatomically. The healing process of the gastric wall following a transgastric… 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
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
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