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Natural orifice transluminal endoscopic surgery

James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
Eduardo E Montalvo-Javé, Braulio A Crisanto-Campos, Jesús Tapia-Jurado, Edgar Montes de Oca-Duran, Luis Humberto Ortega-León, Stefany Alcántara-Medina, German Eduardo Mendoza-Barrera, César Athie Gutierrez
Natural orifice transluminal endoscopic surgery (NOTES) represents an alternative in surgical approach, combined with the progress and experience gained from conventional and endoscopic surgery. Bibliographic research in PubMed, Medline database from 2000 to 2015 and analysis of the literature reviews found. NOTES provides vision and natural orifice approach, it has optimized operating times as well as reduced complications and better cosmetic results. Small series of patients have been reported, but there is not a valid clinical multicenter study by evidence-based medicine...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Przemyslaw Korzeniowski, Daniel C Brown, Mikael H Sodergren, Alastair Barrow, Fernando Bello
The goal of this study was to establish face, content, and construct validity of NOViSE-the first force-feedback enabled virtual reality (VR) simulator for natural orifice transluminal endoscopic surgery (NOTES). Fourteen surgeons and surgical trainees performed 3 simulated hybrid transgastric cholecystectomies using a flexible endoscope on NOViSE. Four of them were classified as "NOTES experts" who had independently performed 10 or more simulated or human NOTES procedures. Seven participants were classified as "Novices" and 3 as "Gastroenterologists" with no or minimal NOTES experience...
September 26, 2016: Surgical Innovation
Chao-Yu Liu, Chen-Sung Lin, Chia-Chuan Liu
The development of minimally-invasive surgery of the thorax began in the 1990s, but not until the recent decade did we see dramatic improvements in patient care and refinement of technique. The current generation has witnessed the evolution from traditional thoracotomy, to a single-port, non-intubated thoracoscopic approach. The investigation of subxiphoid single-port, transumbilical approach, and natural orifice transluminal endoscopic surgery (NOTES) in animal model are also undergoing. In Taiwan, several talented young surgeons have vigorously devoted their ideas and innovations to this field, making the Taiwan surgical society vivid and prosperous...
August 2016: Journal of Thoracic Disease
Stavros N Stavropoulos, David Friedel, Rani Modayil, Henry P Parkman
Achalasia is a rare esophageal motility disorder that is usually idiopathic in origin. It is characterized by dysphagia, and patients often have chest pain, regurgitation, weight loss, and an abnormal barium radiograph showing esophageal dilation with narrowing at the gastroesophageal junction. Abnormal or absent esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) are typically seen on esophageal manometry. The advent of high resolution manometry (HRM) has allowed more precise diagnosis of achalasia, subtype designation, and differentiation from other esophageal motor disorders with an initial seminal publication in 2008 followed by further refinements of what has been termed the Chicago classification...
September 13, 2016: BMJ: British Medical Journal
Katherine A Kelley, V Liana Tsikitis
Appropriate endoscopic resection for colorectal polyps can present a challenge to endoscopists, as these lesions may harbor malignancy. With recent advances in endoscopy, however, we are now entering an exciting frontier of endoscopic therapy for gastrointestinal lesions. These techniques include endoluminal mucosal resection and endoscopic submucosal dissection, which may be utilized on several colonic lesions. This article will discuss these principle endoscopic techniques, their outcomes, and briefly highlight their influence on endoscopic interventions, including transanal endoscopic microsurgery and natural orifice transluminal endoscopic surgery...
September 2016: Clinics in Colon and Rectal Surgery
Nobuyoshi Takeshita, Khek Yu Ho
Full-thickness gastrointestinal defects such as perforation, anastomotic leak, and fistula are severe conditions caused by various types of pathologies. They are more likely to require intensive care and a long hospital stay and have high rates of morbidity and mortality. After intentional full-thickness opening of hollow organs for natural orifice transluminal endoscopic surgery, safe and secure closure is urgently required. The currently available advanced endoscopic closing techniques have a major role in the treatment of full-thickness gastrointestinal defects...
September 2016: Clinical Endoscopy
Cheng Peng, Yan Ling, Chi Ma, Xiaochun Ma, Wei Fan, Weibo Niu, Jun Niu
OBJECTIVE: Natural orifice transluminal endoscopic surgery (NOTES) is an endoscopic technique whereby surgical interventions can be performed with a flexible endoscope passed through a natural orifice (mouth, vulva, urethra, anus) then through a transluminal opening of the stomach, vagina, bladder, or colon. Although in the early stage of research and development, NOTES has been clinically applied across the globe, above all the transvaginal cholecystectomy is among the most frequently performed procedures...
October 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Jan Baekelandt, Peter A De Mulder, Ilse Le Roy, Chantal Mathieu, Annouschka Laenen, Paul Enzlin, Steven Weyers, Ben Wj Mol, Jan Ja Bosteels
INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) uses natural body orifices to access the cavities of the human body to perform surgery. NOTES limits the magnitude of surgical trauma and has the potential to reduce postoperative pain. This is the first randomised study in women bound to undergo hysterectomy for benign gynaecological disease comparing NOTES with classical laparoscopy. METHODS AND ANALYSIS: All women aged 18-70 years, regardless of parity, consulting at our practice with an indication for hysterectomy due to benign gynaecological disease will be eligible...
2016: BMJ Open
Ondrej Ryska, Zuzana Serclova, Jan Martinek, Radek Dolezel, Jaroslav Kalvach, Stefan Juhas, Jana Juhasova, Bohus Bunganic, Eva Laszikova, Miroslav Ryska
BACKGROUND: Novel, less invasive approaches such as single-incision laparoscopic cholecystectomy or natural orifice transluminal endoscopic surgery require preclinical evaluation and training. Therefore, there is a need for an experimental model closely mimicking the clinical situation. The aim of our study was to create an experimental model of calculous cholecystitis in a large laboratory animal and test its feasibility for the evaluation of different techniques of cholecystectomy. METHODS: In 11 laboratory pigs, gallstones were placed inside the gallbladder laparoscopically...
August 5, 2016: Surgical Endoscopy
Karl Jallad, Lauren Siff, Tonya Thomas, Marie Fidela R Paraiso
BACKGROUND: Vaginal hysterectomy is the preferred route of hysterectomy in benign gynecologic disease; however, a vaginal salpingo-oophorectomy can sometimes be technically challenging. Even the most skilled vaginal surgeon will occasionally have to convert to an abdominal approach to complete the procedure. TECHNIQUE: After a vaginal hysterectomy, if the surgeon is struggling to safely complete a salpingo-oophorectomy, a natural orifice transluminal endoscopic surgery (NOTES) approach could be considered...
August 2016: Obstetrics and Gynecology
Ying Hao Tan, Yu Ming Joel Lim, Ying Woo Ng, Ho Yee Tiong
Laparoscopic donor nephrectomy has been broadly recognized as the gold standard for kidney procurement used in kidney transplantation where it is not uncommon for donors to experience discomfort and aesthetic dissatisfaction over larger incision site. Natural orifice transluminal endoscopic surgery is a surgical approach that allows scarless intraabdominal operations through natural orifices, such as the vagina. In this case report, we describe the first case of transvaginal retrieval of donor's kidney at the National University Hospital, Singapore...
September 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yen-I Chen, Mouen A Khashab
PURPOSE OF REVIEW: Malignant gastric outlet obstruction (GOO) is a debilitating complication of cancer associated with a poor prognosis. The primary aim in the management of malignant GOO is usually palliation starting with the reinstitution of luminal patency with either surgical bypass or enteral stenting. These traditional modalities, however, have important limitations. Endoscopic bypass is a novel approach to GOO and may be an ideal technique, in which a sustained bypass can be created through a minimally invasive approach...
July 6, 2016: Current Opinion in Gastroenterology
J Micah Prendergast, Mark E Rentschler
INTRODUCTION: While autonomous surgical robotic systems exist primarily at the research level, recently these systems have made a strong push into clinical settings. The autonomous or semi-autonomous control of surgical robotic platforms may offer significant improvements to a diverse field of surgical procedures, allowing for high precision, intelligent manipulation of these systems and opening the door to advanced minimally invasive surgical procedures not currently possible. AREAS COVERED: This review highlights those experimental systems currently under development with a focus on in vivo modeling and control strategies designed specifically for the complex and dynamic surgical environment...
August 2016: Expert Review of Medical Devices
C Hollinsky
BACKGROUND: Every abdominal incision can lead to early (e. g. abdominal infection) and late complications (e. g. hernia). The correct incision is often important to have optimal access to the surgical area and to keep complications low. OBJECTIVE: An analysis of the recent literature was carried out to clarify which access routes have advantages over other types of incision. MATERIAL AND METHODS: A literature search was carried out in the following databases: Cochrane database of systematic reviews (CDSR), Cochrane library, Medline and PubMed...
September 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Jean-Sébastien Trépanier, María Fernandez-Hevia, Antonio M Lacy
Minimally invasive techniques (MIS) have been evolving quickly in colorectal surgery during the last two decades. Transanal total mesorectal excision (taTME) was developed as a combination of skills acquired from different MIS approaches such as Transanal Endoscopic Microsurgery (TEM), Transanal Minimally Invasive Surgery (TAMIS) and Natural Orifices Transluminal Endoscopic Surgery (NOTES). TaTME allows for a better visualization of surgical planes of dissection and achievement of rectal resection following oncologic principles...
October 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
Przemyslaw Korzeniowski, Alastair Barrow, Mikael H Sodergren, Niels Hald, Fernando Bello
PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique in minimally invasive surgery whereby a flexible endoscope is inserted via a natural orifice to gain access to the abdominal cavity, leaving no external scars. This innovative use of flexible endoscopy creates many new challenges and is associated with a steep learning curve for clinicians. METHODS: We developed NOViSE-the first force-feedback-enabled virtual reality simulator for NOTES training supporting a flexible endoscope...
June 17, 2016: International Journal of Computer Assisted Radiology and Surgery
Yafei Shang, Hongjun Guo, Da Zhang, Fei Xue, Xiaopeng Yan, Aihua Shi, Dinghui Dong, Shanpei Wang, Feng Ma, Haohua Wang, Jianhui Li, Xuemin Liu, Ruixue Luo, Rongqian Wu, Yi Lv
BACKGROUND: Laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery attempt to reduce transabdominal port sites. These require all instruments to pass through a single access point, leading to instruments collide or work at unfamiliar angles. Thus, we designed an internal grasper under magnetic anchoring guide system (MAGS) platform and investigated its utility and operability. METHODS: We measured the configuration for magnetic force decay over distance using a standardized, ex vivo laboratory testing apparatus...
May 13, 2016: Surgical Endoscopy
Zheng Li, Calvin S H Ng
Uniportal VATS poses unique difficulties to the surgeon, mainly as a consequence of operating through a small single incision. The instruments in uniportal VATS have limited movement through the small incision. In addition, the approach to the surgical operating site is unidirectional, which may restrict vision and retraction, and unavoidably suffers from instrument fencing. Recent thoracoscopic technology in the form of a wide variable angled lens has to some extent improved these shortcomings. The development of an extendable flexible thoracoscope and wireless steerable endoscope (WSE) systems can further improve the visualization for surgery and reduce or even remove fencing between endoscope and instruments...
March 2016: Annals of Cardiothoracic Surgery
Ji Hee Kim, Bo-In Lee, Sung Hak Lee, Joon Sung Kim, Myong Ki Baeg, Jae Myung Park, In-Seok Lee, Byung-Wook Kim, Sang Woo Kim, Hwang Choi, Myung-Gyu Choi
BACKGROUND AND AIMS: We evaluated the feasibility of a novel occluder for endoscopic closure of natural orifice transluminal endoscopic surgery (NOTES) gastrotomy. METHODS: The occluder is a self-expandable, membrane-covered, metal structure for endoscopic delivery through gastrointestinal (GI) wall defects. The procedure time and air-tightness of endoscopic closure for a 12-mm perforation were compared for a through-the-scope clip group and an occluder group in an ex vivo animal study...
August 2016: Endoscopy
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