Abstract
We developed a flexible port for NOTES which allows the use of conventional forceps for laparoscope-assisted surgery without change. The port is not affected by the location of the through hole in the gastrointestinal tract or vagina which elicits a problem in conventional NOTES, and its length can be adjusted during surgery by cutting the port itself. The port is made of polymer resin with a low friction coefficient. Furthermore, the port walls have a square wave structure which contributes to (1) the prevention of devices, for example, endoscope, from getting stuck at the time of insertion and retrieval, (2) the prevention of port slippage in the surgical opening for port insertion, (3) the prevention of unexpected port removal, (4) the prevention of port bore deformation, and (5) the improvement of port flexibility in the longitudinal direction. We validated the insertion and retrieval capacities of commercially available forceps for laparoscope-assisted surgery and power devices. Furthermore, we used the flexible port to conduct cholecystectomy and partial gastrectomy. We could confirm that the selection of the flexible port diameter according to the device type allowed the smooth insertion and retrieval of the device and that the port produced no air leakage. We affirmed that it is possible to conduct surgery by the cross or parallel method similarly to single port surgery. We considered that the flexible port has a potential of becoming a revolutionary port in NOTES.
Highlights
We developed a flexible port for Natural orifice transluminal endoscopic surgery (NOTES) which allows the use of conventional forceps for laparoscope-assisted surgery without change
The port is not affected by the location of the through hole in the gastrointestinal tract or vagina which elicits a problem in conventional NOTES, and its length can be adjusted during surgery by cutting the port itself
We considered that the flexible port has a potential of becoming a revolutionary port in NOTES
Summary
Natural orifice transluminal endoscopic surgery (NOTES) is a surgical procedure by which an endoscope penetrates the gastrointestinal (GI) wall through natural orifices, for example, mouth, anus, and vagina, to conduct intra-abdominal surgery. The positional relationship among the natural orifice, the site of GI wall penetration, and the target organ for surgery is important. In problem (1), there are patients for whom surgery cannot be initiated because the port does not reach the site of intra-abdominal penetration in the GI tract or vagina; the port falls from the surgical opening during surgery, requiring a long time for reinsertion. In problem (2), the site of port insertion in the GI tract or vagina which was created to conduct NOTES is injured. Air leakage readily occurs from the site of port insertion in the GI tract or vagina.
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.
