Challenges and lessons learned from NOTES cholecystectomy initial experience: a stepwise approach from the laboratory to clinical application.
Details
Serval ID
serval:BIB_FF445635A669
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Challenges and lessons learned from NOTES cholecystectomy initial experience: a stepwise approach from the laboratory to clinical application.
Journal
Journal of Hepato-biliary-pancreatic Surgery
ISSN
1436-0691 (Electronic)
ISSN-L
0944-1166
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
16
Number
3
Pages
249-254
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND/PURPOSE: The initial idea behind natural orifice transluminal endoscopic surgery (NOTES) was that of an incisionless surgery. NOTES cholecystectomy is a good model of human ingenuity and technological advance. NOTES cholecystectomy in a human being was performed at our institution after extensive laboratory work in live pig models. In this process we gained helpful information related to NOTES cholecystectomy.
METHODS: More than 250 cholecystectomies in pigs have been performed. From May 2007 to November 2008 a total of 10 and 6 transvaginal and transgastric human cholecystectomies, respectively, have been performed.
RESULTS: The procedure was successful in all patients, with a mean operative time of 120 min. There were no intraoperative or postoperative complications. Patients recovered promptly after surgery and had minor postoperative pain. They were discharged on the second postoperative day.
CONCLUSIONS: The advantages of laparoscopy appeared to be enhanced by this approach: patients had minor postoperative pain and minimal scarring. This stepwise experience in the cholecystectomy procedure is an important first step in the development of methods and devices to enable the evaluation of potential incisionless NOTES surgery. Additional research and comparison studies are needed for further improvement in order to provide NOTES procedures to a wider range of patients.
METHODS: More than 250 cholecystectomies in pigs have been performed. From May 2007 to November 2008 a total of 10 and 6 transvaginal and transgastric human cholecystectomies, respectively, have been performed.
RESULTS: The procedure was successful in all patients, with a mean operative time of 120 min. There were no intraoperative or postoperative complications. Patients recovered promptly after surgery and had minor postoperative pain. They were discharged on the second postoperative day.
CONCLUSIONS: The advantages of laparoscopy appeared to be enhanced by this approach: patients had minor postoperative pain and minimal scarring. This stepwise experience in the cholecystectomy procedure is an important first step in the development of methods and devices to enable the evaluation of potential incisionless NOTES surgery. Additional research and comparison studies are needed for further improvement in order to provide NOTES procedures to a wider range of patients.
Keywords
Animals, Cholecystectomy, Laparoscopic/adverse effects, Cholecystectomy, Laparoscopic/methods, Cicatrix/prevention & control, Cohort Studies, Disease Models, Animal, Female, Follow-Up Studies, Humans, Laparoscopes, Male, Minimally Invasive Surgical Procedures/adverse effects, Minimally Invasive Surgical Procedures/methods, Postoperative Complications/physiopathology, Risk Factors, Sensitivity and Specificity, Stomach/surgery, Swine, Treatment Outcome, Vagina/surgery
Pubmed
Web of science
Create date
26/01/2016 22:42
Last modification date
20/08/2019 17:29
Usage data
