Diagnostic Transgastric Endoscopic Peritoneoscopy: Extension of Initial Human Trial for Staging of Pancreatic Head Masses
OBJECTIVE(S): We validated Natural Orifice Translumenal Endoscopic Surgery (NOTES) in a human trial of ten patients undergoing diagnostic transgastric endoscopic peritoneoscopy (DTEP) for staging of pancreatic head masses. Reported herein is an update with 10 additional patients.METHODS: Patients in this IRB approved human trial were scheduled to undergo diagnostic laparoscopy for abdominal staging of a… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Transgastric Endoscopic Peritoneoscopy for Evaluation of the Abdominal Wall, Adhesiolysis and Direction of Trocar Placement in the Morbidly Obese
OBJECTIVE(S): Diagnostic transgastric endoscopic peritoneoscopy (DTEP) has been used as a staging tool to evaluate the abdomen via a natural orifice. Visualization of the abdominal wall is excellent after transgastric endoscopic access. We now present our experience with transgastric endoscopic peritoneoscopy (TEP) to direct trocar placement and adhesiolysis in patients undergoing laparoscopic roux-en-y gastric bypass… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Using External Magnet Guidance and Endoscopically Placed Magnets to Create Suture-free Gastro-enteral Anastomoses
PURPOSE: To facilitate endolumenal and natural orifice procedures, we evaluated a novel technique using external and endoscopically placed magnets in forming suture-free gastro-enteral anastomoses. METHODS: Seven anesthetized adult swine underwent endoscopic placement of differently sized magnets into the small bowel and stomach. Using external magnets, the endoscopically placed internal magnets were brought into opposition under… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES Nephrectomy: Searching for the Best Path
Introduction:Laparoscopic nephrectomy is replacing open radical nephrectomy as the standard of care and it can be performed by a transperitoneal and retoperitoneal approach.Data remain scanty as to whether any objective difference exists between the two approaches.NOTES may shift the decisional paradigm between the two techniques.In the attempt to establish the best way to approach the… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Esophageal Mucosal Resection Diagnostics
INTRODUCTION: Endoscopic four-quadrant forceps biopsy of esophageal dysplasia can be inaccurate due to sampling of Session: Podium Presentation Program Number: S080 Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Natural Orifice Transluminal Endoscopic Surgery (notes) in the Setting of Acute Abdomen:
OBJECTIVE:Laparoscopy has provided a means to assist in the decision-making process for patients with acute abdominal pain. Conditions such as appendicitis, diverticulitis, cholecystitis, small bowel obstruction, perforated viscous, endometriosis, and ovarian cysts can now be safely diagnosed and treated via laparoscopy. With Natural Orifice Transluminal Endoscopic Surgery(NOTES) considered as the next frontier in minimally invasive… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Defining the Host Immune Response to NOTES
Before natural orifice translumenal endoscopic surgery (NOTES) can be safely introduced for human use in the United States, several technical and physiologic factors need to be elucidated. Among these are the host systemic and peritoneal responses to inflammation. The inflammatory response to laparoscopy (LAP) has been well characterized, and has been shown to favorably alter… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
A Simple and Efficient Technique for Natural Orifice Translumenal Endoscopic Surgery (notes) Gastrotomy Closure Utilizing Endoscopic Clips and Loops Facilitated By Temporary Transfascial Sutures
Background: A current limitation in utilizing the stomach as a primary point of access for NOTES is the availability and reliability of the closure devices. The majority of devices described in recent reports are at an investigative or prototype only stage. Here we describe a reliable closure technique using readily available on-shelf endoscopic tools with… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Transgastric Endoscopic Peritoneoscopy Does Not Lead to Increased Risk of Infectious Complications
Introduction: As the field of natural orifice transluminal endoscopic surgery (NOTES) develops it remains important to determine the risk of clinically significant bacterial contamination and infectious complications of the peritoneal cavity. We report herein the bacterial contamination of the peritoneum in patients undergoing transgastric endoscopic peritoneoscopy (TEP) during laparoscopic roux-en-y gastric bypass (LRYGB) to perform… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Clinical Experience with a Multifunctional Flexible Surgery System for Endoluminal, Singe Port and NOTES Procedures
Introduction: Single port and incisionless surgical approaches hold the promise of fewer complications, reduced pain, faster recovery and improved cosmesis compared to traditional open or laparoscopic ones. The ability to select an access approach (i.e., endolumenal, single port, trans-vaginal or trans-gastric) with one platform may be important to optimizing individual patient results.We report our results… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Gynecologic Status After NOTES Transvaginal Cholecystectomy
Background: the development of NOTES procedures and its clinical application raise issues regarding the ways of access to the abdominal cavity. The transvaginal access through posterior colpotomy has been widely used by gynecologists for the treatment of several conditions and eliminates the disadvantages associated with other NOTES approaches ( transgastric, transrectal and trans-vesical). Objective: assessment… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Clinical Results of Alternative Technique for N.o.t.e.s. Transvaginal Cholecystectomy
Objectives: Transvaginal NOTES is a new diagnostic and potentially therapeutic method of surgical endoscopy, and clinical experience is still limited. A preliminary experience with NOTES transvaginal method for cholecystectomy is described.Methods: IRB approval was obtained at the institution for transvaginal NOTES clinical trials. The technique of transvaginal NOTES cholecystectomy was clinically applied in 15patients with… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Clinical Feasability of a New Colonic Access Device (megachannel™) for Interventional Procedures At Colonoscopy: A Prospective, Multicenter Trial
Background: Megachannel™ is a new colonic access system that was originally developed for colonoscopic appendectomy. Once in place, the reinforced wall protects the colon from perforation risks during rapid, multiple passes of the colonoscope to the right colon. The 20mm working channel allows the rapid and safe delivery of bulky instruments such as EUS, banders,… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Physiologic Impact of Prolonged Intra-luminal Insufflation
PHYSIOLOGIC IMPACT OF PROLONGED INTRA-LUMINAL INSUFFLATION.Cedric S.F. Lorenzo MD, Thai H. Pham MD, Kyle A. Perry MD, Blair A. Jobe MD, John G. Hunter MD, Charles R. Phillips MD, Robert O’Rourke MD. Department of Surgery; Oregon Health and Science University, Portland, OR.Introduction: Prolonged intra-luminal and intra-peritoneal insufflation with gas is a critical component of endoluminal… Continue Reading
- Type:
- Posters of Distinction
- Topic:
- Endolumenal / NOTES
NOTES Retroperitoneal Transvaginal Total and Partial Right Nephrectomy
IntroductionAdvantages of transperitoneal and retroperitoneal laparoscopic nephrectomy in comparison to open nephrectomy are well established. The vagina is a viable route for kidney retrieval following laparoscopic nephrectomies. Conceivably, nephrectomy performed through a natural orifice could enhance cosmesis and patients recovery.Aim: to explore trans-vaginal retroperitoneal NOTES total and partial nephrectomy in the porcine model.Materials and methodsTotal… Continue Reading
- Type:
- Video Loop Presentations
- Topic:
- Endolumenal / NOTES