检索结果-南通市图书馆

Natural orifice translumenal endoscopic surgery applications in clinical practice

World Journal of Gastrointestinal Endoscopy 2012年第3期4卷 65-74页

作者： Ross S Coomber Mikael H Sodergren James Clark Julian Teare Ara Darzi Division of Surgery Department of Surgery and CancerImperial College LondonSt.Mary's Hospital

To review natural orifice translumenal endoscopic surgery (NOTES) applications in clinical practice and assess the evidence base for each application as reported in the literature.An electronic literature search was performed.Inclusion criteria were publications relating to NOTES applications in humans.For each type of operation the highest level of evidence available for clinical NOTES publications was evaluated.Morbidity and short-term operative outcomes were compared with gold standard published evidence where available.Finally,registered trials recruiting patients for NOTES applications were identified.Human NOTES publications with the highest level of evidence in each application are identified.There were no RCTs in the literature to date.The strongest evidence came in the form of large,multi-centre trials with 300-500 patients.The results are encouraging,comparable with gold standard techniques on morbidity and mortality.While short-term operative outcomes were also simi-lar when compared to the gold standard techniques,other than improved cosmesis little else can definitely be concluded as a clear benefit of a NOTES procedure.The most common procedures are cholecystectomy,appendicectomy and peritoneoscopy mainly performed via transvaginal access.It is evident that morbidity appears to be higher when the transgastric route is used.The safety profile of hybrid NOTES transvaginal procedures is beginning to be confirmed as is evident from the large number of procedures presented in this review.A number of authors have presented work on pure NOTES procedures but the results are inconsistent and thus the vast majority of NOTES procedures worldwide are performed in a hybrid fashion with a variable amount of laparoscopy.This review of the clinical applications of NOTES summarises the growing evidence behind this surgical discipline and highlights NOTES procedures with an acceptable safety profile.

关键词： Natural orifice translumenal endoscopic surgery Humans Clinical practice

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Natural orifice translumenal surgery:Flexible platform review

引用

World Journal of Gastrointestinal Surgery 2010年第6期2卷 210-216页

作者： Sohail N Shaikh Christopher C Thompson Division of Gastroenterology Brigham and Women's HospitalHarvard Medical School

Natural orifice translumenal surgery(NOTES) has garnished significant attention from surgeons and gastroenterologists,due to the fusion of flexible endoscopy and operative technique.Preliminary efforts suggest that NOTES holds potential for a less invasive approach with certain surgical conditions.Many of the hurdles encountered during the shift from open to laparoscopic surgery are now being revisited in the development of NOTES.Physician directed efforts,coupled with industry support,have brought about several NOTES specific devices and platforms to help address limitations with current instrumentation.This review addresses current flexible platforms and their attributes,advantages,disadvantages and limitations.

关键词： Direct drive endoscopic system Incisionless operating platform Natural orifice translumenal surgery Natural orifice translumenal surgery scope Challenges Attributes

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Natural orifice transesophageal thoracoscopic surgery:A review of the current state

引用

World Journal of Gastrointestinal Endoscopy 2010年第1期2卷 3-9页

作者： Brian G Turner Denise W Gee Gastrointestinal Unit Massachusetts General Hospital55 Fruit StreetBostonMA 02114United States Department of Surgery Massachusetts General Hospital15 Parkman StreetBostonMA 02114United States

Since the concept of Natural Orifice translumenal Endoscopic Surgery(NOTES) was introduced,it has continued to gain significantly in popularity and enthusiasm for its potential clinical applications.The ability to perform conventional laparoscopic and thoracoscopic procedures without the creation of scars and perhaps faster and less painful recovery has prompted a worldwide devotion to further this field.While intraabdominal NOTES has rapidly transitioned from animal models to human trials,applying the NOTES concept to perform thoracic procedures has been slower to gain momentum.The goal of this review is to summarize the current state of transesophageal NOTES thoracoscopy by looking at its potential for diagnostic and therapeutic interventions as well as the challenges in transitioning to human trials.

关键词： Natural orifice translumenal endoscopic surgery Transesophageal Thoracoscopy Mediastinoscopy Esophagotomy Natural orifice Endoscopy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Endoscopic knot tying:In vitro assessment in a porcine stomach model

引用

World Journal of Gastrointestinal Endoscopy 2013年第1期5卷 29-33页

作者： Mihai Ciocirlan Mirela Elena Ionescu Mircea Mihai Diculescu "Carol Davila" University of Medicine and Pharmacy Fundeni Gastroenterology and Hepatology Clinic022328 BucharestRomania Department of Digestive Diseases Edouard Herriot Hospital69437 LyonFrance

AIM:To determine if surgical knotting performed via endoscopy is an effective closure method for natural orifice translumenal endoscopic surgery. METHODS:The proposed method was tested on an in vitro pig stomach model using standard endoscopy suite materials. A single use laparoscopy trocar (Versaport Plus manufactured by Tyco Healthcare) was fixed onto a plastic rectangular box in a horizontal position. A fresh pig stomach was tightly attached via its esophageal end to the trocar opening on the inner side of the box. The stomach cavity was closed at the duodenal end with Kocher forceps. A standard upper gastrointestinal endoscope fitted at its tip with a transparent plastic cap was introduced into the stomach through the outer trocar opening, so that the passage of the surgical trocar would mimic the passage of an esophagus. The stomach was subsequently inflated, followed by irrigation and washing. A neutral electrode of an electrocautery unit was placed inside the plastic box, un-derneath the pig stomach. The stomach's outer surface was kept moist using normal saline in order to maintain the natural elasticity and to ensure good contact with the electrode. RESULTS:The submucosal space on the anterior face of the stomach was accessed using the technique of endoscopic submucosal dissection. First, a site on the anterior face of the stomach was chosen, near the angle. Then, saline was injected into the submucosa with a standard endoscopic needle, so as to create a 20 mm diameter elevation. A linear 15 mm vertical incision was created at its center using a Dual Knife (KD650U manu-factured by Olympus). This incision was used to access the submucosal space, and about 10 mm was dissected on both sides of the incision. The endoscope was then pushed through to the outside of the stomach after dilating a small puncture made by the Dual Knife in the muscularis propria , which simulated the peritoneoscopy procedure. Then, a 0.025" guidewire (Jagwire/450 cm manufactured by Boston Scientific) was inserted into the puncture,

关键词： Endoscopy Endoscopic submucosal dissection Natural orifice translumenal endoscopic surgery Suture in vitro

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Current experience and future directions of completely NOTES colorectal resection

引用

World Journal of Gastrointestinal Surgery 2010年第6期2卷 193-198页

作者： Patricia Sylla Department of Surgery Massachusetts General Hospital

Clinical implementation and widespread application of natural orifice translumenal surgery(NOTES) has been limited by the lack of specialized endoscopic equipment,which has prevented the ability to perform complex procedures including colorectal resections.Relative to other types of translumenal access,transanal NOTES using transanal endoscopic microsurgery(TEM) prov ides a stable platform for endolumenal and direct translumenal access to the peritoneal cavity,and specifically to the colon and rectum.Completely NOTES transanal rectosigmoid resection using TEM,with or without transgastric endoscopic assistance,was demonstrated to be feasible and safe in a swine survival model.The same technique was successfully replicated in human cadavers using commercially available TEM,with endoscopic and laparoscopic instrumentation.This approach also permitted complete rectal mobilization with total mesorectal excision to be performed completely transanally.As in the swine model,transgastric and/or transanal endoscopic assistance extended the length of proximal colon mobilized and overcame some of the difficulties with TEM dissection including limited endoscopic visualization and maladapted instrumentation.This extensive laboratory experience with NOTES transanal rectosigmoid resection served as the basis for the first human NOTES transanal rectal cancer excision using TEM and laparoscopic assistance.Based on this early clinical experience,NOTES transanal approach using TEM holds significant promise as a safe and substantially less morbid alternative to conventional colorectal resection in the management of benign and malignant colorectal diseases.Careful patient selection and substantial improvement in NOTES instrumentation are critical to optimize this approach prior to widespread clinical application,and may ultimately permit completely NOTES transanal colorectal resection.

关键词： Colorectal diseases Transanal endoscopic microsurgery Natural orifice translumenal endoscopic surgery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Single access laparoscopic surgery:Complementary or alternative to NOTES?

引用

World Journal of Gastrointestinal Surgery 2010年第6期2卷 207-209页

作者： Giovanni Dapri Department of Gastrointestinal Surgery European School of Laparoscopic SurgerySaint-Pierre University Hospital

In recent years,single access laparoscopic surgery(SALS) and natural orifice translumenal endoscopic surgery(NOTES) have gained interest from both clinical and industrial point of view,with the increased development of different laparoscopic instruments,production of various access ports,and improvement of operative endoscopes.The main advantages stimulating these two approaches are the cosmetic result,the rapid recovery of the patient,and the reduced need for pain killers.SALS and NOTES are in part complementary and in part alternative techniques.Currently,SALS is much simpler and technically easier than NOTES.

关键词： Single port Single incision Single access Laparoscopy Transumbilical Natural orif ice translumenal endoscopic surgery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

NOTES new frontier:Natural orifice approach to retroperitoneal disease

引用

World Journal of Gastrointestinal Surgery 2010年第5期2卷 157-164页

作者： Pierre Allemann Silvana Perretta Mitsuhiro Asakuma Bernard Dallemagne Jacques Marescaux IRCAD/EITS Institute Strasbourg University Hospital 1 place de l'hpital 67000 Strasbourg France IRCAD/EITS Institute Strasbourg University Hospital1place de l'hpital 67000 Strasbourg France

AIM: To develop a pure transvaginal access to the retroperitoneum, that is simple, reproducible and uses endoscopic material available on the market. METHODS: From February 2008 to April 2009, 31 pigs were operated on, with 17 as an acute experiment and 14 with a survival protocol. The animals were placed in a supine position and a 12-mm double-channel endoscope (Karl StorzTM, Tuttlingen) was used for vision and dissection. During the same time period, the access experiment was reproduced on 3 human cadavers using material similar to that used in the animal model. RESULTS: In the animal model, 37 interventions were done on the kidney, adrenal gland and pancreas. The mean time to fashion the access was 10 min (range 5 to 20 min). No intraoperative death was observed. Two major (5%) intraoperative complications occurred: one hemorrhage on the aorta and one tearing of the right renal vein. Peritoneal laceration was encountered in 5 cases without impairing the planned task. In the survival group, good clinical outcome was observed at a mean follow-up of 3 wk (range 2 to 6 wk). In the 3 cadavers, access was performed correctly. The mean time to fashion the access was 52 min (range 40 to 60 min). All the anatomical landmarks described in the pig model were clearly identified in the same sequence. CONCLUSION: A retroperitoneal natural orifice translumenal surgical transvaginal approach is feasible in both animal and human models and allows performance of a large panel of interventions.

关键词： Nephrectomy Natural orif ice Natural orif ice translumenal surgery Pancreatectomy Retroperitoneum Adrenalectomy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

笔记， MANOS， SILS 和另外的新 laparoendoscopic 技术

引用

World Journal of Gastrointestinal Endoscopy 2012年第6期4卷 212-217页

作者： José F Noguera Angel Cuadrado Consorcio Hospital General Universitario Instituto de Investigación en Ciencias de la Salud46014 ValenciaSpain

A new way of opening a body cavity can be a revolution in surgery.In 1980s,laparoscopy changed how surgeons had been working for years.Natural orifice translumenal endoscopic surgery(NOTES),minilaparoscopy-assisted natural orifice surgery(MANOS),single incision laparoscopic surgery(SILS) and other new techniques are the new paradigm in our way of operating in the 21 st century.The development of these techniques began in the late 90s but they have not had enough impact to develop and evolve.Parallels between the first years of laparoscopy and NOTES can be made.Working for an invisible surgery,not only for cosmesis but for a less invasive surgery,is the target of NOTES,MANOS and SILS performed by surgeons and endoscopists over the last 10 years.The future flexible endoscopic platforms and the fusion between laparoscopic instruments and devices and robotic surgery will be a great advance for 'scarless surgery'.

关键词： Laparoscopy Endoscopy Natural orifice translumenal endoscopic surgery Single incision laparoscopic surgery Minilaparoscopy-assisted natural orifice surgery Flexible endoscopy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：