A reliable detachable balloon that prevents abdominal cavity contamination during transrectal natural orifice transluminal endoscopic surgery

Du, Bing; Fan, Yu; Zhao, Li; Geng, Xin; Li, De liang; Wu, Xiu Wen; Zhang, De Kai; Liu, Bing Rong

doi:10.1111/1751-2980.12757

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…In the latter experiment balloon dislocation of around 2 cm was described. In a further pig experiment with a detachable colon occlusion balloon transrectal cholecystectomy was performed in nine animals with no occurrence of surgical site infection at necropsy 28 days after surgery [30].…”

Section: Discussionmentioning

confidence: 99%

Randomized clinical trial on the use of a colon-occlusion device to assist rectal washout

et al. 2020

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Background Transrectal Natural Orifice Transluminal Endoscopic Surgery is currently limited by the inherent risk of surgical site infection due to peritoneal contamination after rectotomy. Coloshield has been developed as a temporary colon occlusion device to facilitate rectal washout. However, effectiveness and safety has not been evaluated in humans. Methods Twenty-two patients have been randomly assigned to undergo proctological intervention with a rectal washout with and without the use of Coloshield. Patients and assessors were blinded. Boston Bowel Preparation Scale (BBPS) has been determined 30 min as well as immediately after rectal washout. Feasibility, pain, intra- and postoperative morbidity as well as bowel function and continence 6 weeks after surgery were assessed. Results BBPS 30 min after rectal washout with and without Coloshield was in mean 2.42 ± 1.02 and 2.12 ± 0.89 (p = 0.042). Mean BBPS immediately after rectal washout was 2.39 ± 1.02 and 2.24 ± 0.66 (p = 0.269). Mean BBPS immediately after rectal washout and 30 min thereafter did not differ (p = 0.711). Coloshield application was feasible without any complications. The median (interquartile range) numeric rating scale for pain 4 h after surgery was 1 (0–1) and 3 (0–4) (p = 0.212). Six weeks after surgery 0/11 and 1/11 patients suffered from evacuation difficulties (p = 1.0) and the median Vaizey–Wexner score was 1 (0–3) and 1 (0–2) (p = 0.360). Conclusions Coloshield application in humans is feasible and safe. Slight benefits in rectal preparation by washout are found when Coloshield is used. Colon occlusion by Coloshield for transrectal NOTES should be evaluated within clinical studies. Trial registration Clinicaltrials.gov NCT02579330

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Section: Discussionmentioning

confidence: 99%

Randomized clinical trial on the use of a colon-occlusion device to assist rectal washout

et al. 2020

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“…However, like pure-NOTES cholecystectomy, further study and adequately powered comparative A major concern with a transrectal access for NOTES is peritoneal contamination. Du et al invented a balloon that can be utilized to isolate and sterilize the colonic 'operative field'; they found a significant reduction in procedural contamination with balloon use in their animal experiment compared to nonballoon trans-rectal NOTES [23]. This balloon-assisted approach was translated for use in a human subject by Liu et al who reported no postoperative peritonitis [Fig.…”

Section: Flexible Endoscopic Cholecystectomymentioning

confidence: 99%

Advancing flexible endoscopy to natural orifice transluminal endoscopic surgery

Hai

Ali

Liu

2021

Current Opinion in Gastroenterology

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Purpose of review This review is an update on the recent advancements and clinical applications of flexible endoscopy in the context of natural orifice translumenal endoscopic surgery (NOTES). We focus on recent developments in gastrointestinal luminal and transluminal NOTES. Recent findings NOTES has evolved from a hybrid approach utilizing a laparoscopic assistant to pure NOTES without laparoscopic assistance. Current experimental and clinical studies focus on the implementation of new minimally invasive approaches as well as on the training in the use of these procedures. In recent years, flexible endoscopic-NOTES and endoluminal surgery have increasingly reported favorable results in preclinical and experimental settings using flexible endoscopic cholecystectomy, cholecystolithotomy, and appendectomy. Additionally, flexible endoscopic lymphadenectomy and thyroidectomy are among the new interventions that are opening new frontiers for endoscopists to explore. Summary Flexible endoscopy has paved way to new frontiers for endoscopists and surgeons. As the armamentarium of interventional endoscopy increases and the ability of endoscopists to perform advanced interventions safely fosters an inevitable step forward that will involve the integration of new technology with innovative thinking.

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“…Linke et al in 2013 proposed a balloon occluder to be placed cephalad to the penetration site [3,4] and which was tested against conventional laparoscopic cholecystectomy [5]. A similar technology was proposed by Du et al [6]. The technique to enter the abdomen, however, has remained almost unchanged.…”

Section: Introductionmentioning

confidence: 99%

MIEO: a micro-invasive endoscopic operation port system for transluminal interventions—an acute and survival porcine study

et al. 2020

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Background A reliable and sterile access through the intestinal wall to ease flexible endoscopic transluminal interventions is still appealing but lacks a suitable port system. Methods In a granted industry cooperation, we developed the MIEO-Port, a flexible three components overtube system that provides a temporary hermetic sealing of the intestinal wall to allow endoscopic disinfection and manipulation to gain access to the abdominal cavity. The port features an innovative head part which allows for coupling the port to the intestinal wall by vacuum suction and for controlled jetting the isolated intestinal surface with a disinfectant. The device was tested in vivo in 6 pigs for acute and long-term usability. All animal tests were approved by the local ethics committee. Results In the acute experiment, the port system supported sealed endoscopic mucosa resection and transluminal cholecystectomy. In the survival study on 5 animals, the MIEO-Port proved its reliability after transcolonic peritoneoscopy. In one animal, a port dislocation occurred after extensive retroperitoneal preparation, one animal revealed bacterial contamination at necropsy; however, all animals showed a favourable course over ten days and offered no signs of peritonitis or abscedation during post-mortem examination. Discussion To the best of our knowledge, the MIEO-Port system is the first device to provide a reliable and sterile flexible access to the peritoneal cavity that can be used throughout the entire gastrointestinal tract regardless of the access route and which combines hermetic sealing with local sterilization. Further studies are warranted.

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A reliable detachable balloon that prevents abdominal cavity contamination during transrectal natural orifice transluminal endoscopic surgery

Cited by 6 publications

References 28 publications

Randomized clinical trial on the use of a colon-occlusion device to assist rectal washout

Randomized clinical trial on the use of a colon-occlusion device to assist rectal washout

Advancing flexible endoscopy to natural orifice transluminal endoscopic surgery

MIEO: a micro-invasive endoscopic operation port system for transluminal interventions—an acute and survival porcine study

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