Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)

Rolanda, Carla; Lima, Estêvão; Pêgo, José M.; Henriques‐Coelho, Tiago; Schwartz, David A.; Moreira, Ivone; Macedo, Guilherme; Carvalho, José Luís; Correia‐Pinto, Jorge

doi:10.1016/j.gie.2006.07.050

Cited by 166 publications

(108 citation statements)

References 16 publications

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“…In fact, several studies have confirmed the technical feasibility of transgastric diagnostic and therapeutic peritoneoscopy, including liver biopsy, tubal ligation, gastrojejunostomy, cholecystectomy, splenectomy, oophorectomy and partial hysterectomy [7-9, 11-14, 19-20]. In this regard, we showed for the first time that transvesical endoscopic approach to the peritoneal cavity is also feasible and particularly useful to inspect diaphragm and upper abdominal organs [10,16]. Moreover, this approach revealed particularly useful to complement transgastric port, becoming cholecystectomy by natural orifices a reliable procedure, at least in the porcine model [16].…”

Section: Discussionmentioning

confidence: 55%

“…In this regard, we showed for the first time that transvesical endoscopic approach to the peritoneal cavity is also feasible and particularly useful to inspect diaphragm and upper abdominal organs [10,16]. Moreover, this approach revealed particularly useful to complement transgastric port, becoming cholecystectomy by natural orifices a reliable procedure, at least in the porcine model [16]. The feasibility and usefulness of transvesical endoscopic peritoneoscopy for upper abdominal procedures raised the rationale to extend its application to the thoracic cavity.…”

Section: Discussionmentioning

confidence: 92%

“…Within a short period of time, video-assisted thoracic surgery has become an acceptable approach with multiple studies confirming the advantages of thoracoscopy when compared to open procedure, which include shorter hospital stay, rapid recovery and return to physical activity, and excellent cosmetic results [1,18,21]. Recently, innovative natural orifices endoscopic techniques using per-oral transgastric surgery appear to further minimize surgical aggression in what has been designated as third generation surgery [10,16]. In fact, several studies have confirmed the technical feasibility of transgastric diagnostic and therapeutic peritoneoscopy, including liver biopsy, tubal ligation, gastrojejunostomy, cholecystectomy, splenectomy, oophorectomy and partial hysterectomy [7-9, 11-14, 19-20].…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, various authors described more-complex intra-abdominal procedures in porcine models, opening a new era in surgery that is being considered third generation surgery: the natural orifice translumenal endoscopic surgery (NOTES) [7,9,[11][12][13][14][19][20]. Building on these findings, our group described transvesical endoscopic peritoneoscopy as a complementary and safe approach to the abdominal cavity in a porcine model [10,16].…”

Section: Introductionmentioning

confidence: 99%

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Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery

et al. 2007

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Background: Recently there has been an increasing enthusiasm for using natural orifices translumenal endoscopic surgery (NOTES) to perform scarless abdominal procedures. We have previously reported the feasibility and safety of the transvesical endoscopic peritoneoscopy in a long-term survival porcine model as useful for those purposes. Herein, we report our successful experience performing transvesical and transdiaphragmatic endoscopic approach to the thoracic cavity in a long-term survival study in a porcine model. Methods: Transvesical and transdiaphragmatic endoscopic thoracoscopy was performed in six anesthetized female pigs. A 5 mm transvesical port was created on the bladder wall and an ureteroscope was advanced into the peritoneal cavity. After diaphragm inspection, we introduced through the left diaphragmatic dome a ureteroscope into the left thoracic cavity. In all animals, we performed thoracoscopy as well as peripheral lung biopsy. Animals were sacrificed by day 15 postoperatively. Results: We easily introduced a 9.8 Fr ureteroscope into the thoracic cavity that allowed us to visualize the pleural cavity and to perform simple surgical procedures such as lung biopsies without complications. There were neither respiratory distress episodes nor surgical complications to report. Postmortem examination revealed complete healing of vesical and diaphragmatic holes, whereas no signs of infection or adhesions were observed in the peritoneal or thoracic cavities. Conclusion: This study demonstrates the feasibility of transvesical thoracoscopy in porcine model. However, although this study extends the potential applications of NOTES to the thoracic cavity, new instruments and further work are needed to provide evidence that this could be translated to humans and with advantages for patients.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery

et al. 2007

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“…Soon it became apparent that this access was not only a major shift in how the bladder was seen, but also a safe and fast means of access to the peritoneal cavity, with an excellent view of all the upper peritoneal structures [7]. This same group of researchers also described the execution of complex surgical procedures, including nephrectomy [8] and cholecystectomy [9,10], which were carried out by an approach combining the transvesical port with the transgastric port. In both surgical procedures, the transvesical port represented not only a working port through which many instruments are used, but also a way of support and guidance in choosing the site of entry into the peritoneal cavity via the transgastric port [9,10].…”

Section: Introductionmentioning

confidence: 99%

Transvesical peritoneoscopy with rigid scope: feasibility study in human male cadaver

et al. 2010

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Background Transvesical port refers to the method of accessing the abdominal cavity through a natural orifice (i.e., urethra) under endoscopic visualization. Since its introduction in 2006, various reports have been published describing different surgical interventions using a rigid ureteroscope in a porcine model. The aim of this study was to test the access and feasibility of peritoneoscopy by using a rigid ureteroscope in a human male cadaver.Methods Two adult male cadavers were used to perform the procedures. A rigid ureteroscope was used for the creation of transvesical access into the peritoneal cavity. Peritoneoscopy, liver biopsy, and identification and manipulation of the ileocecal appendix were performed. Results Transvesical access into the peritoneal cavity was quickly established. The rigid ureteroscope easily allowed visualization of the abdominal cavity with good image quality. Liver biopsy and manipulation of ileocecal appendix were carried out without difficulties. Conclusions Peritoneoscopy, liver biopsy, and ileocecal appendix manipulation using a rigid ureteroscope through a transvesical port is feasible in a cadaver model. The development of a specific rigid scope for the transvesical port might herald a promising future for this NOTES access.

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Surgery Without Scars

Marescaux

Dallemagne²,

Perretta³

et al. 2007

Arch Surg

698

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Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)

Cited by 166 publications

References 16 publications

Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery

Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery

Transvesical peritoneoscopy with rigid scope: feasibility study in human male cadaver

Surgery Without Scars

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