Comparison of intraabdominal pressures using the gastroscope and laparoscope for transgastric surgery

Abstract

Use of an on-demand unregulated endoscopic light source/insufflator for translumenal surgery can cause large variation in intraperitoneal pressures and intraabdominal hypertension, leading to the risk of hemodynamic and respiratory compromise. Safety may favor well-controlled intraabdominal pressures achieved with a standard autoregulated laparoscopic insufflator.

Natural Orifice Transluminal Endoscopic Surgery: Transgastric Cholecystectomy in a survival porcine model

“…If the first issue can be addressed using a PEG-like technique in the transgastric route, the latter is not yet integrated into the conventional flexible endoscopes [11,12]. There is still a need for transparietal monitoring using a laparoscopic Veress needle.…”

Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Cholecystectomy in a Morbidly Obese Patient

“…Closure of the vaginal wound is not a problematic issue of the approach and was done under direct vision with conventional instruments. Insufflation problems are also a matter of concern in NOTES procedures in animal research [15][16][17]. In a previous publication [8], the procedure was possible also with low pressures (5-6 mmHg) of capnoperitoneum using transvaginal insufflation.…”

Totally NOTES (T-NOTES) transvaginal cholecystectomy using two endoscopes: preliminary report

“…Recent experimental studies are providing an understanding of the physiologic effects of insufflation and infection in natural orifice surgery [23][24][25][26][27][28][29]. Insufflation with ambient air promoted through the working or insufflation channel of the endoscope proved to be dangerous and unreliable in experimental settings [27][28][29]. We attached a plastic nasogastric tube to the first gastroscope (retracting/insufflating endoscope) by sutures to obtain reliable abdominal insufflation with CO 2 using a laparoscopic insufflator adjusted for a pressure of 10 mmHg of CO 2 .…”