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| 篇名 |
Natural Orifice Transluminal Endoscopic Surgery-Transgastric and Transvaginal Biliary Endosurgeryin a Porcine Model |
| 作者 |
Hurng-Sheng Wu, Chien-Hua Lin, Min-Chang Hung, Der-aur Chou,Yueh-Tsung Lee, Der-Aur Chou, Chien-Hua Chen, De-Chuan Chan,Chin-Hung Hsu, Meng-Hang Wu, Min-Ho Huang |
| 卷期/出版年月 |
42卷1期 (2009/2) |
| 頁次 |
13-19 |
| 摘要 |
Objectives: To determine the technical feasibility and safety of using a flexible
endoscope to perform peroral transgastric and transvaginal cholecystectomy in a
porcine model.
Methods: Transgastric and transvaginal cholecystectomy was performed in 3 male
and 2 female pigs respectively, in nonsurvival studies. Access to the peritoneal cavity
was performed through a double-channel flexible videogastroscope. The peritoneal
cavity was insufflated with air through a Veress needle which also served to monitor
the pneumoperitoneum. The gallbladder was easily visualized by both routes. Using
an endoscopic grasper and a unipolar round-tipped electrode, the gallbladder was
dissected from the liver bed, once the cystic duct and artery were both clipped and
divided.
Results: Transgastric and transvaginal flexible endoscopic cholecystectomy was
performed successfully in five pigs. There were no complications during gastric wall
incision and entrance into the peritoneal cavity. Visualization of the visceral organs
including gallbladder was very clear. Identification of the cystic duct, both proximal
and distal clipping, and then transection and detachment of the gallbladder from the
liver bed were achieved using standard endoscopic devices and accessories. The
flexible endoscope after transgastric access the peritoneal cavity needed retroflexion
to approach the gallbladder, while transvaginal route was more direct, allowing an
easy in-line view and access to the gallbladder. The average operating time was 166
min in transgastric and 80 min in transvaginal routes of access.
Conclusions: Our study revealed technical feasibility and possible safety of
possible transgastric and transvaginal cholecystectomy, and we found that the
transvaginal method is more feasible than others. We hope that this can be used in
humans in the near future. |
| 關鍵詞 |
N.O.T.E.S. (Natural Orifice Transluminal Endoscopic Surgery),cholecystectomy, flexible endoscope, transvaginal |
| 分類 |
Original Article |
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