This video demonstrates a novel, transesophageal endoscopic technique for mediastinal and thoracic lymph node dissection and en bloc lymphadenectomy using a Natural Orifice Transluminal Endoscopic Surgery (NOTES®) technique. Using a swine model, a double-channel gastroscope equipped with an endoscopic cap band mucosectomy device is used to create a small esophageal mucosal defect. Next, a short […]
Background:Traditional approach for surgical management of mature pancreatic pseudocysts is by internal drainage by cystgastrostomy or cystjejunostomy via open or laparoscopic approaches. Endoscopic drainage procedures have been described; however, they require multiple interventions and are sometimes not definitive. We describe NOTES® (Natural Orifice Translumenal Endoscopic Surgery) stapled cystgastrostomy as a less invasive surgical procedure for […]
INTRODUCTION: Safe esophageal closure remains a challenge in transesophageal Natural Orifice Transluminal Endoscopic Surgery (NOTES) procedures. Suturing or t-tag devices are time consuming and risk organ injury due to their blind deployment. Endoclips are difficult to place in the narrow esophagus and submucosal tunneling techniques do not necessarily prevent leakage of esophageal contents into the […]
Introduction. Natural orifice transluminal endoscopic surgery (NOTES) makes it possible to perform intraperitoneal surgical procedures with a minimal number of access points in the abdominal wall. At the present time these procedures are hybrids. It is expected a better cosmetic result and lower incidence in parietal complications in front of laparoscopic cholecystectomy, but is necessary […]
Aims. Evaluation of the efficiency and reproductibility of hybrid transvaginal endoscopic surgery in non-elective surgical procedures to treat intraabdominal infections caused by acute cholecystitis, appendicitis or tubo-ovarian infection. Methods. Prospective non-randomized clinical series of ten selected female patients with acute intraabdominal infection caused by acute cholecystitis (n=6), appendicitis (n=2) and pelvic infection of tubes or […]
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 […]
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 […]
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 […]
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 […]
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 […]