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  • 1 Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary
  • | 2 Department of Surgery, Markus Krankenhaus, Frankfurt am Main, Germany
  • | 3 Kodály Z. u. 20, H-7624, Pécs, Hungary
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Abstract

Introduction:The Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an abdominal operation carried out with flexible endoscopic instruments and their advanced versions via natural orifices. The NOTES causes theoretically less pain, operative stress, shorter hospitalization, quicker recovery and it is scarless. The aim of this investigation was to evaluate the feasibility and safety of transgastric small bowel resection. Materials and methods: Seven domestic pigs were investigated and entered the study; body weight 25 kg in average. General anesthesia was performed. One trocar was used for laparoscopic observations during gastrotomy and transgastric penetration with the gastroscope, later for assistance with a grasper for manipulation of the bowel loops and for the application of the linear stapling device. Then the needle knife was used to complete a 1.5 cm long incision in the gastric wall. The gastroscope was advanced into the peritoneal cavity and a small bowel loop was identified and elevated with a flexible grasper. Through the second channel of the scope a coag grasper was used to dissect the mesentery. Then a linear stapler was inserted through the assisting trocar and the resection was performed. Afterwards the bowel ends were opened with the needle knife and the stapler was reinserted for a side-to-side anastomosis. The specimen was removed via the stomach. Gastric closure was completed by laparoscopic mini-instruments through the stapler-port. All special events and all problems were prospectively documented. Follow-up was performed over 2 weeks and body weight was recorded. Then a laparoscopy was performed to document adhesions or abscess formation. Finally the animals were sacrificed to evaluate further evidence of infection or adhesions. Results: The operations were carried without complications, there was no case of letal outcome. On the 12th day the abdominal laparoscopic revision was carried out, after the revision in one case adhesion could be detected, no other kinds of complications were noticed. Conclusion: According to our results, the transgastric small bowel resection is a safe procedure, but further special instruments are needed. These experimental procedures should be evaluated carefully and critically in clinical practice.

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2019  
Scimago
H-index
11
Scimago
Journal Rank
0,220
Scimago
Quartile Score
Medicine (miscellaneous) Q3
Scopus
Cite Score
155/133=1,2
Scopus
Cite Score Rank
General Medicine 199/529 (Q2)
Scopus
SNIP
0,343
Scopus
Cites
206
Scopus
Documents
23

 

Interventional Medicine and Applied Science
Language English
Size  
Year of
Foundation
2009
Publication
Programme
changed title
Volumes
per Year
 
Issues
per Year
 
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2061-1617 (Print)
ISSN 2061-5094 (Online)

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