Abstract
Transrectal access still has some unsolved issues such as spatial orientation, infection, access and site closure. This study presents a simple technique to perform transcolonic access with survival in a swine model series. A new technique for NOTES perirectal access to perform retroperitoneoscopy, peritoneoscopy, liver and lymphnode biopsies was performed in 6 pigs, using Totally NOTES technique. The specimens were extracted transanally. The flexible endoscope was inserted through a posterior transmural incision and the retrorectal space. Cultures of bacteria were documented for the retroperitoneal space and intra abdominal cavity after 14 days. Rectal site was closed using non-absorbable sutures. There was no bowel cleansing, nor preoperative fasting. The procedures were performed in 6 pigs through transcolonic natural orifice access using available endoscopic flexible instruments. All animals survived 14 days without complications, and cultures were negative. Histopathologic examination of the rectal closure site showed adequate healing of suture line and no micro abscesses. The results of feasibility and safety of experimental Transcolonic NOTES potentially brings new frontiers and future wider applications for minimally invasive surgery. The treatment of colorectal, abdominal and retroperitoneal diseases through a flexible Perirectal NOTES Access (PNA) is a promising new approach.
Highlights
Natural orifice surgery has gain supporters as a promising new alternative to incisional and laparoscopic surgery for abdominal procedures
A new technique for natural orifice transluminal endoscopic surgery (NOTES) perirectal access to perform retroperitoneoscopy, peritoneoscopy, liver and lymphnode biopsies was performed in 6 pigs, using Totally NOTES technique
Cultures of bacteria were documented for the retroperitoneal space and intra abdominal cavity after 14 days
Summary
Natural orifice surgery has gain supporters as a promising new alternative to incisional and laparoscopic surgery for abdominal procedures Potential benefits such as avoid surgical incision complications led to the first successful series of clinical applications, reported in literature, for transvaginal and transgastric natural orifice transluminal endoscopic surgery (NOTES) (Pasricha and Krummel 2009, Sodergreen et al 2009, Voermans et al 2010, Zorron et al 2010a, Fuchs et al 2013, Katagiri et al in press., Meillat et al 2016). There are some technical obstacles to solve before standardization of trancolonic approach, such as the risk of infection, safe entrance in the abdominal cavity and closure of reliable colonic. Based on those issues, our research group developed a new flexible technique to perform a transcolonic procedure in animals. We developed a trasncolonic perirectal acces to allow therapy inside abdominal cavity and retroperitoneal space
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
