Trangastric access to the chest: opening a new vista?
Introduction:The NOTES approach to the peritoneal cavity is well established today and procedures in humans have already been performed. The next question to be addressed is whether this access can be extended further. This video shows the feasibility of feasibility of transgastric access to the thoracic cavity in the porcine model.Materials and methods:A series of… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES: Transvaginal Cholecystectomy with Assisting Articulating Instruments
Introduction: Transvaginal cholecystectomy has been performed at several institutions using the hybrid NOTES techniques. Methods: The patient is a 42 year old female with symptomatic cholelithiasis. After obtaining informed consent, the patient was taken to the operating room for transvaginal cholecystectomy. A single 5 mm laparoscope was placed at the umbilicus, followed by a 15mm… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Magnetic Retraction for NOTES Transvaginal Cholecystectomy
Introduction: Natural orifice surgery (NOTES) has the potential to decrease the burden of an operation on a patient. Limitations of the endoscopic platform require innovative solutions to provide retraction and create an operation comparable to the gold standard, laparoscopic cholecystectomy. Methods: Four patients underwent transvaginal cholecystectomy. All procedures were performed under laparoscopic vision to ensure… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES sigmoid resection
Bakground:NOTES Colonic resection is difficult to perform because of the need for exposure, dissection, vascular control and anastomosis. The aim of the present study was to evaluate the feasibility and early results of combined transgastric-transrectal NOTES sigmoidectomy.Materials and Methods:A two-week survival study was undertaken to evaluate the combined trangastric-transrectal approach for sigmoidectomy in 5 mini-pigs.… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
An Endosurgical Operating System: Initial Human Experience in Endolumenal and NOTES Procedures
Background: Minimally invasive surgery is rapidly evolving with the promise of new endolumenal and translumenal surgical procedures performed with few or no external incisions. We describe our early human experience with a flexible platform technology that provides stable access and visualization, force transmission, two-handed tissue manipulation and durable tissue approximation. The EndoSurgical Operating System (EOS),… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Endoscopic Endoluminal Radiofrequency Ablation of Barrett’s Esophagus: Initial Results and Lessons Learned
Background: Ablating Barrett’s epithelium may reduce the risk of developing esophageal adenocarcinoma. This study reports the initial experience of a single surgeon using an endoscopic endoluminal device delivering radiofrequency energy (the BARRx device) in ablating Barrett’s esophagus.Methods: All patients who underwent ablation of Barrett’s epithelium with the BARRx system were reviewed for length of Barrett’s… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Rigid Transvaginal Retraction in Hybrid NOTES Cholecystectomy
Introduction: As techniques of natural orifice translumenal endoscopic surgery (NOTES) improve, the safe performance of totally translumenal surgery is becoming more feasible. In a previous report of a hybrid approach to natural orifice transvaginal cholecsytectomy we noted difficulty with gallbladder retraction and could only accomplish this transabdominally.We present a novel technique and instrument that allows… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Trans Oral Endoscopic Stapled Esophago Diverticulostomy (toesed ) for Zenker’s Diverticulum
Introduction: Zenker's diverticulum is a known cause for dysphagia and is treated usually by resection or diverticulopexy through a neck incision. In recent years an endoscopic per-oral method has been described. A cohort of patients was treated and long-term follow up was obtained.Materials and Methods: All patients presented with the diagnosis of Zenker's diverticulum were… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Randomized blinded trial comparing NOTES with laparoscopy reveals no difference in immunologic parameters
Background: Natural Orifice Transluminal OrificeSurgery (NOTES) is being investigated for human use as a new minimally invasive procedure. We compared NOTES with the current gold standard laparoscopy.Hypothesis: Animals undergoing NOTES will reveal greater hemodynamic instability due to uncontrolled insufflation pressures. No difference in the immunologic impact as measured by Interleukin-1b will be realized.Design: Randomized blinded… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
The Impact of Proton Pump Inhibitors on Intra-peritoneal Sepsis:
Study Aim: Proton pump inhibitors (PPI) are commonly given for the treatment of GERD and ulcer disease. In many non-operative cases of perforated ulcer disease, it is standard of care. During transgastric NOTES procedures there is an iatrogenic perforation of the gastric wall with leakage of gastric contents into the peritoneal cavity. Our study aim… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
The First Human Abdominal Surgery in Prone Position: An Example of How NOTES Can Be Used to Perform Unique Procedures
NOTES has been touted as the next step in minimally invasive surgery. As such, most of the effort to perform NOTES has been focused on reproducing surgical procedures in a manner similar to how they are accomplished laparoscopically. It seems, however, that a potential advantage for NOTES is to allow surgeons to perform operations in… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Analysis of 1,543 Gastric Carcinoid Patients for Proposed Staging System
Background: Gastric carcinoid tumors are rare and little is known about the long term prognosis of these tumors, since no staging system currently exists. The aim of this study was to create a predictive staging system to accurately estimate prognosis. Methods: A retrospective review of 15,983 carcinoid patients from the SEER database identified 1,543 patients… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Esophageal / Gastric Surgery
Results after laparoscopic Heller-Dor operation for esophageal achalasia in 100 consecutive patients
Background: Laparoscopic Heller-Dor operation (LHD) has been the procedure of choice for the treatment of esophageal achalasia. However since, the incidence of achalasia is low, at one in 100,000 in USA and Japan, reports on the outcome of surgical treatment for such a disease are limited. In this study, we investigated the therapeutic results after… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Esophageal / Gastric Surgery
A laparoscopic vagus preserving Merendino procedure
Introduction: Laparoscopic vagal preserving oesophagectomy is a recognised treatment option for high grade dysplasia of the oesophagus[1]. A jejunal interposition, as described by Alvin Merendino in 1955[2], aims to substitute the lower oesophageal sphincter, thereby treating physiological disorders such as reflux oesophagitis. Methods: We aimed to combine these procedures in the treatment of an otherwise… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Esophageal / Gastric Surgery
Anti-reflux Surgery Is Not Totally Effective Against Esophageal Adenocarcinoma, Despite the Regression or Disappearance of Barrett’s Esophagus in Most Cases – A Study of 80 Barret’s Patients.
BACKGROUND: Barrett’s Esophagus (BE) is a complication of gastroesophageal reflux disease (GERD) and can be a pre-malignant condition. laparascopic anti-reflux surgeries (LARS) significantly correct physiological and anatomical abnormalities in patients with GERD; nevertheless, there is no consensus about its effectiveness in preventing malignant transformation in patients with BE. The impact of LARS on those suffering… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Esophageal / Gastric Surgery