Accessibility of peritoneal organs according to the routes of approach in NOTES

Chul Yong Kim, Hoon-Jai Chun, Ju Young Kim, Jin Su Jang, Yong Dae Kwon, Sanghoon Park, Bora Keum, Yeon Seok Seo, Yong Sik Kim, Yoon Tae Jeen, Hong Sik Lee, Soon-Ho Um, Sang Woo Lee, Jai Hyun Choi, Chang Duck Kim, Ho Sang Ryu

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2 Citations (Scopus)

Abstract

BACKGROUND/AIMS: Natural orifice transluminal endoscopic surgery (NOTES) is a new era of minimally invasive surgery which has the potential to offer scarless surgery. So far, numerous reports on various routes to peritoneal organs in NOTES have been published. In case of transgastric approach, it is more inconvenient than transcolonic approach to access upper abdominal organs because of retroflexion. However, most data were subjective and there was no report examining the best access route for the exploration of peritoneal organs. The aim of this study was to evaluate the best access route according to the abdominal organs objectively. METHODS: Six female pigs weighing 30 to 35 kg were placed under general anesthesia. Incisions were made on both anterior wall of stomach body and rectosigmoid colon 15 to 20 cm above anal verge, respectively. Then, via each incision site, we evaluated the endoscopic visibility and checked the elapsed time to access abdominal organs in sequence [(gallbladder (GB), spleen, bladder, uterus, and ovary)]. RESULTS: On comparison of the mean time to approach each organs, GB and ovary showed statistical difference in the mean time to approach between transgastric and transcolonic approaches. It took relatively shorter time to access GB via transcolonic route than transgastric route (352.3+/-80.1 sec vs. 222.2+/-82.0 sec, p=0.021). Next, we evaluated the time to access upper organs (GB and spleen) and lower organs (bladder, uterus and ovary). In case of lower organs, it showed no difference in time between transgastric and transcolonic approaches. However, to explore upper organs, transcolonic route was more favorable than transgastric route (351.8+/-80.7 sec vs. 273.3+/-110.3 sec, p=0.002). CONCLUSIONS: For exploration of lower organs, there is statistically no significant difference in time between transgastric and transcolonic approaches. But, in case of upper organs, transcolonic approach is superior to transgastric approach.

Original languageEnglish
Pages (from-to)281-285
Number of pages5
JournalThe Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
Volume52
Issue number5
Publication statusPublished - 2008 Nov 1

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Natural Orifice Endoscopic Surgery
Gallbladder
Ovary
Uterus
Urinary Bladder
Spleen
Minimally Invasive Surgical Procedures
General Anesthesia
Stomach
Colon
Swine

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Accessibility of peritoneal organs according to the routes of approach in NOTES. / Kim, Chul Yong; Chun, Hoon-Jai; Kim, Ju Young; Jang, Jin Su; Kwon, Yong Dae; Park, Sanghoon; Keum, Bora; Seo, Yeon Seok; Kim, Yong Sik; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon-Ho; Lee, Sang Woo; Choi, Jai Hyun; Kim, Chang Duck; Ryu, Ho Sang.

In: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi, Vol. 52, No. 5, 01.11.2008, p. 281-285.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND/AIMS: Natural orifice transluminal endoscopic surgery (NOTES) is a new era of minimally invasive surgery which has the potential to offer scarless surgery. So far, numerous reports on various routes to peritoneal organs in NOTES have been published. In case of transgastric approach, it is more inconvenient than transcolonic approach to access upper abdominal organs because of retroflexion. However, most data were subjective and there was no report examining the best access route for the exploration of peritoneal organs. The aim of this study was to evaluate the best access route according to the abdominal organs objectively. METHODS: Six female pigs weighing 30 to 35 kg were placed under general anesthesia. Incisions were made on both anterior wall of stomach body and rectosigmoid colon 15 to 20 cm above anal verge, respectively. Then, via each incision site, we evaluated the endoscopic visibility and checked the elapsed time to access abdominal organs in sequence [(gallbladder (GB), spleen, bladder, uterus, and ovary)]. RESULTS: On comparison of the mean time to approach each organs, GB and ovary showed statistical difference in the mean time to approach between transgastric and transcolonic approaches. It took relatively shorter time to access GB via transcolonic route than transgastric route (352.3+/-80.1 sec vs. 222.2+/-82.0 sec, p=0.021). Next, we evaluated the time to access upper organs (GB and spleen) and lower organs (bladder, uterus and ovary). In case of lower organs, it showed no difference in time between transgastric and transcolonic approaches. However, to explore upper organs, transcolonic route was more favorable than transgastric route (351.8+/-80.7 sec vs. 273.3+/-110.3 sec, p=0.002). CONCLUSIONS: For exploration of lower organs, there is statistically no significant difference in time between transgastric and transcolonic approaches. But, in case of upper organs, transcolonic approach is superior to transgastric approach.",
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AU - Chun, Hoon-Jai

AU - Kim, Ju Young

AU - Jang, Jin Su

AU - Kwon, Yong Dae

AU - Park, Sanghoon

AU - Keum, Bora

AU - Seo, Yeon Seok

AU - Kim, Yong Sik

AU - Jeen, Yoon Tae

AU - Lee, Hong Sik

AU - Um, Soon-Ho

AU - Lee, Sang Woo

AU - Choi, Jai Hyun

AU - Kim, Chang Duck

AU - Ryu, Ho Sang

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