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
Intestinal Occlusion Catheter for Natural Orifice Translumenal Endoscopic Surgery (notes)
Background: Significant bowel distention can result from lumenal gas insufflation during NOTES procedures. This can reduce the peritoneal cavity operative domain. Bowel distention may be more apparent with tunneling-type access techniques that require more time to cross the viscus wall. Objective: Utilizing commercially available products, we designed an intestinal occlusion catheter (IOC) that can be… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
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
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
Natural Orifice Transesophageal Mediastinoscopy and Thoracoscopy: A Survival Series in Swine
Introduction: Mediastinoscopy (MX) and thoracoscopy (TX) are common procedures with painful incisions and prominent scars. A natural orifice transesophageal endoscopic surgery (NOTES) approach could reduce pain, eliminate intercostal neuralgia, provide access to the posterior mediastinal compartment or hilum, and improve cosmesis. The purpose of this study is to create a survival animal model for NOTES… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Endolumenal Anastomosis Creation with Magnets
Objective: Creation of a safe endolumenal gastro-jejunal anastomosis with neodymium magnets.Background: This paper describes a new technique for performing an endolumenal gastro-jejunal anastomosis using neodymium magnets.Methods: An experimental survival study was conducted in seven swine with open translumenal placement of variable shaped magnets in the stomach and jejunum. An anastomosis was created between magnets in… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Natural Orifice Translumenal Endoscopic Surgery (NOTES) Peritoneoscopy Versus Laparoscopy to evaluate Intra-Abdominal Pathology in a Porcine Model
Background: The decision to operate on the intensive care patient with a questionable abdominal source of sepsis continues to prove difficult despite advancements in radiographic imaging. We believe a bedside trans-gastric NOTES exploration could be a valuable diagnostic tool in this setting.Methods: An acute, non-survival, study of 8 pigs was performed. Pigs were randomized to… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Burst Pressures in Gastric Closure – a NOTES Comparison Study of Looped T-Anchors vs. Endoclips in the Explanted Porcine Stomach
Background: A reliable, secure closure of the gastrotomy remains a fundamental challenge in transgastric NOTES procedures. Gastrotomy closure using endoscopic clips is unreliable, technically difficult, and expensive. Few tests of the integrity of these closures have been published. We compared burst pressures in gastric explants utilizing looped T-anchors and endoscopic clips.Methods: In nine explanted porcine… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Novel Endoscope Fixation for Natural Orifice Transgastric Cholecystectomy
Introduction: Transgastric, scar-free cholecystectomy is an electrifying prospect. Unfortunately, multiple barriers have hampered early investigation into this technique. Some of the principle obstacles encounered are; a gastroscope which is too flexible for adequate dissection, a surgical site that is located at almost 180° from the direction of scope insertion requiring retro-flexion and significant scope looping,… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Impact of Transoral Incisionless Fundoplication Fasteners on Lower Esophageal Sphincter Anatomy & Physiology: A Balancing Act
INTRODUCTION: Transoral incisionless fundoplication (TIF) may have improved outcomes over simple, single shot, endoscopic therapy because it allows the surgeon to tailor the fundoplication to the gastro-esophageal (GE) anatomy by placing transmural fastener sets in critical GE locations. How each successive fastener set impacts LES valve anatomy and physiology is unknown. METHODS & PROCEDURES: While… Continue Reading
- Type:
- Posters
- 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
Durability of a Novel Full Thickness Percutanous Endoscopic Sleeve Gastroplasty (pesg): Survival Study
Background: Percutaneous endoscopic sleeve gastroplasty (PESG) may have a role as a restrictive weight loss procedure. We hypothesize that we can safely perform a durable PESG using full thickness endoluminal plications. Methods: After developing the PESG on ex-vivo porcine stomachs and 6 non-survival procedures, we tested the durability by performing 6 survival procedures on 30… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Maximizing Coupling Strength of Magnetically Anchored NOTES Instruments: How Thick Can We Go?
Introduction: The Magnetic Anchoring and Guidance System (MAGS) includes a handheld external magnet that controls deployable internal surgical instruments (camera, auxiliary light source, grasper, retractors, and cautery dissector) via magnetic attraction forces. We have successfully performed transvaginal NOTES cholecystectomy using MAGS instruments in porcine models with up to 2.5cm thick abdominal walls. The purpose of… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Microbial Contamination of the Peritoneum Is Common Following Transgastric Endoscopic Surgery
INTRODUCTION: In Natural Orifice Transluminal Endoscopic Surgery (NOTES), intentional perforation of viscus to access the peritoneal cavity violates basic principles of surgery and raises questions regarding its safety. The aim of this study was to investigate if the transgastric approach could affect the peritoneal cavity by transluminal contamination. MATERIALS AND METHODS: A total of 7… Continue Reading
- Type:
- Posters
- 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