J Korean Soc Coloproctol.  2007 Dec;23(6):397-402. 10.3393/jksc.2007.23.6.397.

Transgastric Gastroscopic Intra-abdominal Exploration in a Female Dog Model: NOTES (Natural Orifice Transluminal Endoscopic Surgery)

• Kim YI
• Park JH
• Lee SI
• Jeong SM
• Kim JY

• KMID: 2199190
• DOI: http://doi.org/10.3393/jksc.2007.23.6.397

Abstract

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new surgical option using endoscopic advancement to the peritoneal cavity through the stomach, colon, vagina, or urinary bladder without an abdominal wall scar (incision). The aim of this study was to assess the feasibility of transgastric gastroscopic intra-abdominal exploration with gastric incision and closure before the NOTES would be done.
METHODS
Under general anesthesia of a female dog, one-channel gastroscope was advanced to the stomach and the lumen was irrigated with anti-bacterial solution. The anterior wall of the antrum was incised by about 1 cm with a needle knife; then, the gastroscope was advanced into the peritoneal cavity. An exploration of the entire intra-abdominal cavity was performed.
RESULTS
We were able to evaluate the stomach, the greater omentum, the diaphragm, the peritoneum, the urinary bladder, the bowel, the spleen, the liver, the gallbladder, the uterine horn, the uterine body, and the vagina, but could not evaluate the ovary, the kidney, and the pancreas. The observation of the abdominal cavity was followed by the gastric wall closure with a 135o endoclip. The dog was recovered after confirmation of secure closure of the incision site.
CONCLUSIONS
Transgastric incision, closure, and abdominal exploration are feasible without an abdominal wall scar, and the NOTES can be one option for future abdominal operations in humans and needs to be further investigated.

Keyword

NOTES; Transgastric gastroscopic intra-abdominal exploration

MeSH Terms

Abdominal Cavity
Abdominal Wall
Anesthesia, General
Animals
Cicatrix
Colon
Diaphragm
Dogs*
Female*
Gallbladder
Gastroscopes
Horns
Humans
Kidney
Liver
Natural Orifice Endoscopic Surgery
Needles
Omentum
Ovary
Pancreas
Peritoneal Cavity
Peritoneum
Spleen
Stomach
Urinary Bladder
Vagina