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首页> 外文期刊>Surgical Endoscopy >Pure transvesical NOTES appendectomy using a 5-mm rigid laparoscope: A feasibility and survival study with porcine models
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Pure transvesical NOTES appendectomy using a 5-mm rigid laparoscope: A feasibility and survival study with porcine models

机译：使用5毫米刚性腹腔镜进行纯经膀胱NOTES阑尾切除术：猪模型的可行性和生存性研究

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Background: Previously, the authors demonstrated the feasibility of a pure transvesical natural orifice translumenal endoscopic surgery (NOTES) for uterine horn resection (UHR) using a rigid ureteroscope in swine as an appendectomy model. However, visualization was poor, and there was room for improvement. The authors have assessed the feasibility and safety of a revised technique that uses a 5-mm rigid laparoscope. Methods: Eight operations on four female pigs (35-40 kg) were performed as a proof of concept study. Four right-side operations were performed in a survival model. The surgical procedure was similar to the original technique. However, the rigid ureteroscope was replaced by a 5-mm laparoscope after modification of the access system. In addition, the clipped metal threads used for bladder closure were easily placed with a long 13-gauge needle. In the survival model, a Foley catheter was placed for 1 day. Results: The new technique provided considerably better visualization and operability than the original technique. The mean total operative time was 96.6 ± 18.2 min, and the mean estimated blood loss was 15.0 ± 13.5 ml. On postoperative day 3, pig 2 in the survival study died of peritonitis resulting from a small bowel injury. The lab results for the other pigs demonstrated no adverse events and tolerable immune responses. Necropsy showed complete healing of the vesicotomy. Conclusions: The revised transvesical NOTES UHR technique improved the outcomes and feasibility of the original technique. This approach may be translatable to human appendectomy procedures in the future.
机译：背景：以前，作者证明了使用刚性输尿管镜在猪中作阑尾切除术模型的纯经膀胱自然孔经腔内镜手术（NOTES）进行子宫角切除（UHR）的可行性。但是，可视化效果很差，还有改进的空间。作者评估了使用5毫米刚性腹腔镜的改良技术的可行性和安全性。方法：对四头雌猪（35-40公斤）进行了八次手术，作为概念验证研究。在生存模型中执行了四个右侧操作。手术程序与原始技术相似。但是，在修改进入系统后，用5毫米腹腔镜代替了刚性输尿管镜。另外，用于膀胱闭合的金属线夹很容易用长13号针头放置。在生存模型中，将Foley导管放置1天。结果：新技术提供了比原始技术更好的可视化和可操作性。平均总手术时间为96.6±18.2分钟，平均估计失血量为15.0±13.5 ml。术后第3天，存活研究中的猪2因小肠损伤而死于腹膜炎。其他猪的实验室检查结果未显示不良事件和可耐受的免疫反应。尸检显示膀胱切开术完全愈合。结论：经修订的经膀胱NOTES UHR技术改善了原始技术的疗效和可行性。这种方法将来可能会转化为人类阑尾切除术。

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