Journal article
A review of 130 humans enrolled in transgastric NOTES protocols at a single institution
Surgical endoscopy, Vol.25(4), pp.1004-1011
2011
DOI: 10.1007/s00464-010-1369-3
PMID: 20976500
Abstract
Background: The methodology of Natural Orifice Translumenal Endoscopic Surgery (NOTES) has been validated in both human and animal models. Herein is a discussion of our experience gained from the initial 130 patients enrolled in transgastric pre-NOTES and NOTES protocols at our institution.
Methods: A retrospective review of our research database was performed for all patients enrolled in NOTES protocols. The infectious risk of a gastrotomy with and without a NOTES procedure was assessed in 100 patients. Eighty patients completed a true NOTES protocol looking at staging, access, and insufflation with select patients evaluating the potential for bacterial contamination of the abdominal compartment.
Results: A total of 130 patients have completed pre-NOTES and NOTES protocols at our institution. We observed no clinically significant contamination of the abdomen secondary to transgastric procedures in 100 patients. Diagnostic transgastric endoscopic peritoneoscopy (DTEP) was completed in 20 patients with pancreatic head masses and found to have a 95% concordance with laparoscopic exploration for assessment of peritoneal metastases. Blind endoscopic gastrotomy and DTEP were evaluated in 40 patients who underwent laparoscopic Roux-en-Y gastric bypass procedures (LSRYGB) and were found to be safe, reliable, and without a clinically significant risk of contamination. Endoscopic peritoneal insufflation was successfully established and correlated with standard laparoscopic insufflation in 20 patients.
Conclusions: Transgastric NOTES is a safe alternative approach to accessing the peritoneal cavity in humans. The risk of bacterial contamination secondary to peroral and transgastric access is clinically insignificant. A device for the facile closure of the gastric defect is the sole factor limiting institution of this methodology as a standalone technique.
Details
- Title: Subtitle
- A review of 130 humans enrolled in transgastric NOTES protocols at a single institution
- Creators
- Peter NAU - Division of General Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United StatesE. Christopher ELLISON - Department of Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United StatesPeter MUSCARELLA - Division of General Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United StatesDean MIKAMI - Center for Minimally Invasive Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United StatesVimal K NARULA - Division of General Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United StatesBradley NEEDLEMAN - Center for Minimally Invasive Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United StatesW. Scott MELVIN - Center for Minimally Invasive Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United StatesJeffrey W HAZEY - Division of General Surgery, The Ohio State University School of Medicine and Public Health, 410 West 10th Avenue, Columbus, OH 43210-1228, United States
- Resource Type
- Journal article
- Publication Details
- Surgical endoscopy, Vol.25(4), pp.1004-1011
- Publisher
- Springer; New York, NY
- DOI
- 10.1007/s00464-010-1369-3
- PMID
- 20976500
- ISSN
- 0930-2794
- eISSN
- 1432-2218
- Language
- English
- Date published
- 2011
- Academic Unit
- Surgery
- Record Identifier
- 9984051994902771
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