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• W2025932397 abstract "Introduction: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a new and evolving approach for abdominal surgery. Although in early development, this approach avoids abdominal incisions and thus has the potential to reduce operative morbidity. We conducted a systematic review of animal studies to assess the feasibility of NOTES. Methods: MEDLINE (from 1966-2006) and abstracts of gastroenterology and surgical scientific meetings in the last 5 years were searched. All animal studies involving natural orifice to gain access to peritoneal cavity were included. Standard forms were used to extract data regarding study design, orifice used for access, pre-op preparations, closure of access site, nature of study (long-term survival vs. non-survival study), primary outcomes and complications by two independent reviewers. Results: Thirteen studies met the inclusion criteria. All studies involved porcine animal models. Transgastric approach was used in 11 studies, transcolonic (for cholecystectomy) and transvesical approach (for peritoneoscopy) in one study each. The target organs varied among the studies (gallbladder, small intestine, uterus, fallopian tube, spleen, lymph nodes and the peritoneal cavity). The primary outcome varied among the studies: cholecytectomy, gastrojejunostomy, splenectomy, ligation of fallopian tubes/ovaries, peritoneoscopy, gastropexy, liver biopsy, bowel anastomosis and lymphadenectomy. 11 studies performed long-term survival studies in some of the animals in the study. The upper endoscope was used in 9 studies (Olympus GIF 2T 100, 140, 160, 2T 160). 3 studies used the linear array echoendoscope (Pentax) and 1 study used the cytoscope and uteroscope (for peritoneoscopy). 7 studies administered IV antibiotics (penicillin, cephalosporins and enrofloxin), while 5 studies also applied antibiotics luminally. The size of puncture sites varied among the studies (5 mm-20 mm). The sites were dilated with balloon dilators in 4 studies. Closure of the sites was done with either endoscopic clips, endoloop or sutures. Two studies reported unsuccessful closure of the puncture sites (1/5 animals in each study). The operative time varied from 20 mins to 4 hrs. The primary outcome was achieved in all the studies. Complications reported were (1 each in different studies): bleeding (2 animals), gastric perforation and intra-abdominal abscess (1/5 animals), peritonitis (1/5 animals) and adhesions (4/5 animals). Conclusions: Current studies have shown the feasibility of NOTES in animals. More long-term survival studies are needed to assess post-operative complications. More studies are also needed to assess the non-transgastric approaches for NOTES." @default.
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• W2025932397 date "2007-04-01" @default.
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• W2025932397 title "NOTES: A Systematic Review of Animal Studies" @default.
• W2025932397 doi "https://doi.org/10.1016/j.gie.2007.03.690" @default.
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