Animal models of laparoscopy assisted natural orifice translumenal endoscopic surgery / 中华消化内镜杂志

ABSTRACT

Objective To explore the manipulation,feasibility and safety of laparoscopy assisted natural orifice translumenal endoscopic surgery(NOTES).Methods The technique was performed in 4 female porcine models.Diagnostic laparoscopy was performed first,and followed by transgastric access through the anterior gastric wall under the monitor of laparoscopy.The stoma was extended with the dilation ballon and the endoscope was sent to the abodominal cavity.Such procedures as endoscopic peritoneoseopy,fallopian tube ligation,oophorectomy,eholeeysteetomy and closure of gastrostomy were performed.The drainage tube and antibiotics of 3 days were used after operation according to the bleeding and potential risk of fistula and peritonitis.The animals were feeded on a semiliquid diet.Two weeks later,routine gastroseopy was pedbrmed to examine the healing of luminal incision.Subsequently,all models were sacrificed for the evaluation of the validity of NOTES.Results With the assistance of the laparoscope,endoscopic peritoneoseopy and,fallopian tube ligation,oophorectomy and cholecystectomy,twice for each,were successfully performed in all models.Abdominal drainage were used in two animals'after eholecystectomy.All porcines survived for 2 weeks postoperatively with no weight loss.Autopsic examination showed good healing of transgastric incisions,with little adhesion,no massive heinan'hage,abcesses,or injury to adjacent organs.Conclusion Combined laparoscopy and endoscopy for NOTES is feasible with relative safety.Laparoscopic assistance could facilitate the NOTES procedures at the present stage.