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 […]
Purpose: Chronic pelvic pain affects many women in reproductive age in the US and laparoscopy is common in the diagnostic algorithm. In the realm of NOTES, a transvaginal approach would be a natural approach to reduce incision sites, postoperative pain and improve cosmesis in this patient population. This is the first report of transvaginal diagnostic […]
Background: Endoscopic submucosal dissection (ESD) is proving effective in the resection of selected early stage gastrointestinal cancers. Its application and appropriateness could be extended if a means of determining lymphatic dissemination could be provided without recourse to conventional operation. Here we demonstrate the performance of companion sentinel node biopsy (SNB) by Natural Orifice Translumenal Endoscopic […]
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 […]
Introduction: Intraabdominal surgery using a flexible endoscope combines the skills of both gastroenterologists (GI) and minimally invasive surgeons (MIS). Deficiencies in each of these standard training models include the lack of familiarity with complex intraabdominal maneuvers, for physicians with a GI background, and difficulty operating without a fixed horizon, for those with an MIS background.Materials […]