Peroral Transgastric Cholecystectomy:a Case Report of Two Human Patients
Aim: NOTES represents an emerging technology, including under its umbrella a variety of approaches and combinations. We present 2 human patients who underwent transgastric cholecystectomy. Methods: In April 2008, 2 patients underwent transgastric cholecystectomy at our institute. The procedure entailed the use of a double-channel endoscope, a 3-mm umbilical port for retraction of gall bladder… 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
Pure NOTES Cholecystectomy
Initial excitement for Natural Orifice Transluminal Endoscopic Surgery (NOTES) has been partly tempered by the reality that a NOTES procedure without laparoscopic or needleoscopic-assistance has not been widely performed. After safely performing laparoscopically-assisted transvaginal cholecystectomy in an IACUC-approved porcine model, we embarked on an IRB-approved protocol to ultimately perform a pure NOTES cholecystectomy.We describe our… Continue Reading
- Topic:
- Endolumenal / NOTES
Reducing the Unexpectedly High Rate of Injuries Caused By NOTES Gastrotomy Creation
INTRODUCTION: This study was conducted to identify the incidence and types of complications related to gastrotomy creation with the needle knife puncture and balloon dilatation technique for NOTES access to the peritoneal cavity.METHODS AND PROCEDURES: Between May 2007 and August 2008, 113 NOTES experiments were performed at a single institution with transgastric endoscopic access achieved… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Reverse NOTES: Esophageal Canalization
Introduction: Traditional natural orifice translumenal endoscopic surgery (NOTES) involves entry through a pre-existing orifice such as the mouth, anus or vagina. A surgically created “orifice” such as a gastrostomy can also be used as an access site, performing a reverse NOTES surgery. This video describes such reverse access to treat a complete esophageal occlusion following… Continue Reading
- Topic:
- Endolumenal / NOTES
Scarless One Port Transumbilical Laparoscopic Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy is usually performed using several trocars. We report a case of a single port sleeve gastrectomy in a 42 year-old, female morbidly obese with a BMI of 42 kg/m2. Through a 2-cm single transumbilical incision Triport® was inserted and roticulator instruments were used. To retrieve the specimen we partially used the device… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Small Bowel Resection and Anastomosis Using \”notes\”: Lessons Learned in a Survival Model
INTRODUCTION: Natural orifice translumenal endoscopic surgery (NOTES) has been used for a number of technically straightforward surgical procedures. However, to date, no one has reported using NOTES technique for small bowel resection and anastomosis in a survival model.METHODS AND PROCEDURES: All studies were conducted in accordance with Institutional Animal Care and Use Committee (IACUC) protocols.… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Survival Study of NOTES Rectosigmoid Resection Using Transanal Endoscopic Microsurgery (tem) with or Without Transgastric Endoscopic Assistance in a Swine Model
INTRODUCTION: Our group has previously demonstrated the feasibility of NOTES rectosigmoid resection in a swine cadaver model using TEM alone or in combination with transgastric endoscopic assistance to extend the length of colon mobilization. METHODS: A survival study of transanal endoscopic rectosigmoid resection with stapled coloanal anastomosis was conducted in swine using TEM (n=8) and… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
The Development and Testing of a Tethered, Independent Camera for NOTES and Single-site Laparoscopic Procedures
Background:“Tunnel vision” associated with flexible endoscopes used in NOTES and rigid laparoscopes used in Single Site Laparoscopic (SSL) procedures can present the surgeon with a disorienting view of familiar surroundings. Because the working tools are in-line with the view in these approaches, it is also difficult to achieve adequate instrument triangulation, a critical component of… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
The Development and Testing of New Rigid and Flexible Fixation Staplers for NOTES Applications
Background:Many of the devices used in early human NOTES procedures were originally designed for intralumenal work and are therefore limited in functionality due to constraints imposed by current flexible endoscopes. The invention of large diameter flexible trocars, however, has opened the door for delivery of true surgical capabilities such as stapling. Additionally, the transvaginal approach… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
The Diagnostic Efficacy of Natural Orifice Translumenal Endoscopic Surgery (notes): Is There a Role in the Intensive Care Unit?
Background: Evaluation of a potential source of abdominal sepsis in a critically ill patient can be challenging. With flexible endoscopy being readily available in this setting, we sought to evaluate the diagnostic efficacy of a trans-gastric NOTES peritoneoscopy vs. laparoscopic exploration in the identification of common intra-abdominal pathology in a porcine model.Methods: In this acute… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Tissue Apposition System (tas) – New Technology to Minimize Surgery for Endoscopically Unresectable Colonic Polyps
Introduction: This study reports the first clinical series using the TAS device in a feasibility study of endoscopic polypectomy as an alternative to laparoscopic colectomy (LC) for endoscopically unresectable polyps. TAS is a novel T-tag system for endoscopic placement of sutures which facilitates closure of larger defects from advanced endolumenal or translumenal endoscopic procedures. Such… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Total Transgastric Appendectomy: A Reality
Objective: Natural orifice surgery is evolving into viable option for surgeons to have in their armamentarium. Totally NOTES operations have remained elusive due to safety concerns. The ability to safely enter the abdominal cavity blindly has remained a challenge therefore requiring one to multiple ports through the abdominal wall to observe entrance into the abdominal… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Trans-oral Endoscopic Removal of an Eroded Adjustable Gastric Band
Erosion of a laparoscopic adjustable band is a feared complication occurring in less than 0.5% of placed cases. Once diagnosed, removal is imperative. The options for removal include open, laparoscopic and endoscopic approaches. We present for review a video case presentation of an endoscopic removal of an intragastric erosion of an adjustable gastric band. Our… Continue Reading
- Topic:
- Endolumenal / NOTES
Transesophageal Mediastinal Lymph Node Sampling.
1. Objective of the study: Improved minimally invasive lymph node sampling for cancer staging and diagnosis of mediastinal lymphadenopathy is desirable. Natural orifice approaches may offer improved minimally invasive options. We have previously reported on the technical feasibility and the potential low risk of transesophageal mediastinoscopy using the submucosal endoscopy with mucosal flap safety valve… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES