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Trans-umbilical endoscopic cholecystectomy with a water-jet hybrid-knife:A pilot animal study

World journal of Gastroenterology 2013年第40期19卷 6857-6862页

作者： Sheng-jun jiang Hong shi gyanendra Swar Hai-Xia Wang Xiao-jing Liu Yong-Guang Wang Department of Minimally Invasive Surgery Beijing Chuiyangliu Hospital Department of Gastrointestinal Endoscopy Fujian Provincial Tumor HospitalTeaching Hospital of Fujian Medical University Institute of Minimally Invasive Medicine Tongji University

AIM:To investigate the feasibility and safety of Natural orifice trans-umbilical endoscopic cholecystectomy with a water-jet hybrid-knife in a non-survival porcine ***:Pure natural orifice transluminal endoscopic surgery(NOTES) cholecystectomy was performed on three non-survival pigs,by transumbilical approach,using a water-jet hybrid-knife. Under general anesthesia,the following steps detailed the procedure:(1) incision of the umbilicus followed by the passage of a double-channel flexible endsocope through an overtube into the peritoneal cavity;(2) establishment of pneumoperitoneum;(3) abdominal exploration;(4)endoscopic cholecystectomy:dissection of the gallbladder performed using water jet equipment,ligation of the cystic artery and duct conducted using nylon loops;and(5) necropsy with macroscopic ***:Transumbilical endoscopic cholecystectomy was successfully completed in the first and third pig,with minor bleedings. The dissection times were 137and 42 min,respectively. The total operation times were 167 and 69 min,respectively. And the lengths of resected specimen were 6.5 and 6.1 cm,*** of the fluid into the gallbladder bed produced edematous,distended tissue making separation safe and easy. Reliable ligation using double nylon loops insured the safety of cutting between the *** were no intraoperative complications or hemodynamic instability. Uncontrolled introperative bleeding occurred in the second case,leading to the operation ***:Pure NOTES trans-umbilical cholecystectomy with a water-jet hybrid-knife appears to be feasible and safe. Further investigation of this technique with long-term follow-up in animals is needed to confirm the preliminary observation.

关键词： Natural orifice transluminal endoscopic surgery Cholecystectomy Water-jet Hybrid-knife Triangulation

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