Toward Natural Orifice Surgery with Cooperative Miniature Robots
Introduction: While Natural Orifice Translumenal Endoscopic Surgery (NOTES) is very appealing from the patient’s perspective, it is surgically challenging by its very nature because access is limited to the size of the natural orifice. It is difficult to have multiple instruments simultaneously passing through an orifice, and the instruments must be flexible throughout their entirety… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Lessons Learned About Informed Consent in 9 Attempted NOTES Cases
Objective: the advent of the NOTES approach_ either transvaginal or transgastric_ has raised issues regarding the informed consent process_ required from an ethical and legal point of view_ as well as doubts from the patients regarding the indication and justification of the operation. Methods and procedures: starting August 2007, we attempted to perform 9 NOTES… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Natural Orifice Cholecystectomy Using a Miniature Robot
Introduction: Natural Orifice Translumenal Endoscopic Surgery (NOTES) is surgically challenging. Current endoscopic tools provide an insufficient platform for visualization and manipulation. This study demonstrates the feasibility of using a miniature in vivo robot to enhance visualization and provide off-axis dexterous manipulation capabilities for NOTES. Methods: We developed a dexterous, miniature robot with six degrees-of-freedom capable… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Human Transvaginal Cholecystectomy using an IT-Knife
Background: NOTES is an evolving and controversial field of surgery on its beginning. Laparoscopic surgery and Endoscopy merges to fulfill it. Despite NOTES human experience had begin by the transgastric way with Rao in India, the transvaginal approach is taking place as a safer and easy way to achieve the upper abdomen. As on its… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Transgastric Endoscopic Peritoneoscopy Does Not Require Decontamination of the Stomach in Humans
Introduction: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a rapidly evolving field that provides endoscopic access to the peritoneum via a natural orifice. One important requirement of this technique is the need to minimize the risk of clinically significant peritoneal contamination. We report the bacterial load and contamination of the peritoneal cavity in patients undergoing… 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
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
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
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
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
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
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