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Endoscopy 2009; 41(1): 36-41
DOI: 10.1055/s-0028-1103455
Review

© Georg Thieme Verlag KG Stuttgart · New York

Success and complication parameters for laparoscopic surgery: a benchmark for natural orifice transluminal endoscopic surgery

C.  N.  Gutt1 , B.  P.  Müller-Stich1 , M.  A.  Reiter1
  • 1Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
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Publication History

Publication Date:
21 January 2009 (online)

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Background: Natural orifice transluminal endoscopic surgery (NOTES) currently represents an issue of particular interest among surgeons and gastroenterologists. The principle of NOTES is the reduction of the operative trauma by using natural orifices of the human body to access the abdominal cavity. Regarding the tendency to further minimization of the surgical trauma, NOTES may be considered as a logical step in the evolution of minimally invasive surgery. Pioneers of this technique regard NOTES as the successor to laparoscopic surgery in enabling surgeons and gastroenterologists to conduct scarless surgery. This might not only lead to better cosmetic results but also enhance the prospect of decreases in wound infections and incisional hernias, as well as reducing operative stress, postoperative immobility, and pain.

Material and methods: In this article the authors collect and review the existing literature concerning NOTES and establish a benchmark for the assessment of this new technique by stating results from conventional minimally invasive surgery as the gold standard.

Conclusion: It is shown that publications investigating possible advantages or long-term results of NOTES are scarce. However, the investigation and verification of potential advantages and disadvantages represent the most important step in the development of a new technique. Only proven advantages would justify the broad implementation of a new technique in relation to its specific risks. Conventional laparoscopic surgery as the current standard of minimally invasive surgery will be the benchmark for NOTES with regard to most issues. Superiority of NOTES in at least several issues would be the best argument for its further implementation into clinical practice.

References

  • 1 Gettmann M T, Lotan V, Napper C. A et al. Transvaginal laparoscopic nephrectomy: development and feasibility in the porcine model.  Urology. 2002;  59 446-450
    CrossrefPubMedGoogle Scholar
  • 2 Kalloo A N, Singh V K, Jagannath S B. et al . Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity.  Gastrointest Endosc. 2004;  60 114-117
    CrossrefPubMedGoogle Scholar
  • 3 Bergstrom M, Ikeda K, Swain P, Park P O. Transgastric anastomosis by using flexible endoscopy in a porcine model.  Gastrointest Endosc. 2006;  63 307-312
    CrossrefPubMedGoogle Scholar
  • 4 Feretis C, Kalantzopoulos D, Koulouris P. et al . Endoscopic transgastric procedures in anesthetized pigs: technical challenges, complications, and survival.  Endoscopy. 2007;  39 394-400
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Fritscher-Ravens A, Mosse C A, Ikeda K, Swain P. Endoscopic transgastric lymphadenectomy by using EUS for selection and guidance.  Gastrointest Endosc. 2006;  63 302-306
    CrossrefPubMedGoogle Scholar
  • 6 Hu B, Kalloo A N, Chung S. et al . Peroral transgastric endoscopic primary repair of a ventral hernia in a porcine model.  Endoscopy. 2007;  39 390-393
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Jagannath S B, Kantsevoy S V, Vaughn C A. Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model.  Gastrointest Endosc. 2005;  61 449-453
    CrossrefPubMedGoogle Scholar
  • 8 Kantsevoy S V, Jagannath S B, Niiyama H. Endoscopic gastrojejunostomy with survival in a porcine model.  Gastrointest Endosc. 2005;  62 287-292
    CrossrefPubMedGoogle Scholar
  • 9 Kantsevoy S V, Hu B, Jagannath S B. Transgastric endoscopic splenectomy: is it possible?.  Surg Endosc. 2006;  20 522-525
    CrossrefPubMedGoogle Scholar
  • 10 Mathes K, Yusuf T E, Willingham F F. Feasibility of endoscopic transgastric distal pancreatectomy in a porcine animal model.  Gastrointest Endosc. 2007;  66 762-766
    CrossrefPubMedGoogle Scholar
  • 11 Merrifield B F, Wagh M S, Thompson C C. Peroral transgastric organ resection: a feasibility study in pigs.  Gastrointest Endosc. 2006;  63 693-697
    CrossrefPubMedGoogle Scholar
  • 12 Onders R P, McGee M F, Marks J M. et al . Natural orifice transluminal endoscopic surgery (NOTES) as a diagnostic tool in the intensive care unit.  Surg Endosc. 2007;  21 681-683
    CrossrefPubMedGoogle Scholar
  • 13 Park P O, Bergstrom M, Ikeda K. et al . Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis.  Gastrointest Endosc. 2005;  61 601-606
    CrossrefPubMedGoogle Scholar
  • 14 Perretta S, Dallemagne B, Coumaros D, Marescaux J. Natural orifice transluminal endoscopic surgery: transgastric cholecystectomy in a survival porcine model.  Surg Endosc. 2008;  22 1126-1130
    CrossrefPubMedGoogle Scholar
  • 15 Sumiyama K, Gostout C J, Rajan E. et al . Transgastric cholecystectomy: transgastric accessibility to the gallbladder improved with the SEMF method and a novel multibending therapeutic endoscope.  Gastrointest Endosc. 2007;  65 1028-1034
    CrossrefPubMedGoogle Scholar
  • 16 Swanstrom L L, Kozarek R, Pasricha P J. et al . Development of a new access device for transgastric surgery.  J Gastrointest Surg. 2005;  9 1129-1137
    CrossrefPubMedGoogle Scholar
  • 17 Wagh M S, Merrifield B F, Thompson C C. Endoscopic transgastric abdominal exploration and organ resection: initial experience in a porcine model.  Clin Gastroenterol Hepatol. 2005;  3 892-896
    CrossrefPubMedGoogle Scholar
  • 18 Wagh M S, Merrifield B F, Thompson C C. Survival studies after endoscopic transgastric oophorectomy and tubectomy in a porcine model.  Gastrointest Endosc. 2006;  63 473-478
    CrossrefPubMedGoogle Scholar
  • 19 Clayman R V, Box G N, Abraham J B. Rapid communication: transvaginal single-port NOTES nephrectomy: initial laboratory experience.  J Endourol. 2007;  21 640-644
    CrossrefPubMedGoogle Scholar
  • 20 Fong D G, Pai R D, Thompson C C. Transcolonic endoscopic abdominal exploration: a NOTES survival study in a porcine model.  Gastrointest Endosc. 2007;  65 312-318
    CrossrefPubMedGoogle Scholar
  • 21 Fong D G, Ryou M, Pai R D. et al. Transcolonic ventral wall hernia mesh fixation in a porcine model.  Endoscopy. 2007;  39 865-869
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Fritscher-Ravens A, Patel K, Ghanbari A. et al . Natural orifice transluminal endoscopic surgery (NOTES) in the mediastinum: long-term survival animal experiment in transesophageal access, including minor surgical procedures.  Endoscopy. 2007;  39 870-875
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Lima E, Rolanda C, Pego J M. et al . Transvesical endoscopic peritoneoscopy: a novel 5 mm port for intra-abdominal scarless surgery.  J Urol. 2006;  176 802-805
    CrossrefPubMedGoogle Scholar
  • 24 Lima E, Rolanda C, Pego J M. et al . Third-generation nephrectomy by natural orifice transluminal endoscopic surgery.  J Urol. 2007;  178 2648-2654
    CrossrefPubMedGoogle Scholar
  • 25 Meining A, Wilhelm D, Burian M. et al . Development, standardization, and evaluation of NOTES cholezystectomy using a transsigmoid approach in the porcine model: an acute feasibility study.  Endoscopy. 2007;  39 860-864
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Mintz Y, Horgan S, Cullen J, Falor E. et al . Dual-lumen natural ofirice translumenal endoscopic surgery (NOTES): a new method for performing a safe anastomosis.  Surg Endosc. 2007;  22 348-351
    PubMedGoogle Scholar
  • 27 Pai R D, Fong D G, Bundga M E. et al . Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model.  Gastrointest Endosc. 2006;  64 428-434
    CrossrefPubMedGoogle Scholar
  • 28 Rolanda C, Lima E, Pego J M. et al . Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach.  Gastrointest Endosc. 2007;  65 111-117
    CrossrefPubMedGoogle Scholar
  • 29 Ryou M, Fong D G, Pai R D. et al . Dual-port distal pancreatectomy using a prototype endoscope and endoscopic stapler: a natural orifice transluminal endoscopic surgery (NOTES) survival study in a porcine model.  Endoscopy. 2007;  39 881-887
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Scott D J, Tang S, Fernandez R. et al . Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments.  Surg Endosc. 2007;  21 2308-2316
    CrossrefPubMedGoogle Scholar
  • 31 Shih S P, Kantsevoy S V, Kalloo A N. et al . Hybrid minimally invasive surgery – a bridge between laparoscopic and translumenal surgery.  Surg Endosc. 2007;  21 1450-1453
    CrossrefPubMedGoogle Scholar
  • 32 Sumiyama K, Gostout C J, Rajan E. et al . Transesophageal mediastinoscopy by submucosal endoscopy with mucosal flap safety valve technique.  Gastrointest Endosc. 2007;  65 679-683
    CrossrefPubMedGoogle Scholar
  • 33 Whiteford M H, Denk P M, Swanstrom L L. Feasibility of radical sigmoid colectomy performed as natural orifice transluminal endoscopic surgery (NOTES) using transanal endoscopic microsurgery.  Surg Endosc. 2007;  21 1870-1874
    CrossrefPubMedGoogle Scholar
  • 34 Wilhelm D, Meining A, von Delius S. et al . An innovative, safe and sterile sigmoid access (ISSA) for NOTES.  Endoscopy. 2007;  39 401-406
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Willingham F F, Gee D W, Lauwers G Y. et al . Natural orifice transesophageal mediastinoscopy and thoracoscopy.  Surg Endosc. 2008;  22 1042-1047
    CrossrefPubMedGoogle Scholar
  • 36 Branco A W, Branco F ilho, Kondo W. et al . Hybrid transvaginal nephrectomy.  Eur Urol. 2008;  53 1290-1294
    CrossrefPubMedGoogle Scholar
  • 37 Gettmann M T, Blute M L. Transvesical peritoneoscopy: initial clinical evaluation of the bladder as a portal for natural orifice transluminal endoscopic surgery.  Mayo Clin Proc. 2007;  82 843-845
    CrossrefPubMedGoogle Scholar
  • 38 Hazey J W, Narula V K, Renton D B. et al . Natural-orifice transgastric endoscopic peritoneoscopy in humans: initial clinical trial.  Surg Endosc. 2008;  22 16-20
    CrossrefPubMedGoogle Scholar
  • 39 Marescaux J, Dallemagne B, Perretta S. et al . Surgery without scars.  Arch Surg. 2007;  142 823-827
    CrossrefPubMedGoogle Scholar
  • 40 Narula V K, Happel L C, Volt K. et al . Transgastric endoscopy peritoneoscopy does not require decontamination of the stomach in humans.  Surg Endosc. 2008;  [Epub ahead of print]
    PubMedGoogle Scholar
  • 41 Steele K, Schweitzer M A, Lyn-Sue J, Kantsevoy S V. Flexible transgastric peritoneoscopy and liver biopsy: a feasibility study in human beings.  Gastrointest Endosc. 2008;  68 61-66
    CrossrefPubMedGoogle Scholar
  • 42 Zornig C, Emmermann A, von Waldenfels H A, Mofid H. Laparoscopic cholecystectomy without visible scar: combined transvaginal and transumbilical approach.  Endoscopy. 2007;  39 913-915
    Article in Thieme ConnectPubMedGoogle Scholar
  • 43 Zorron R, Maggioni L C, Pombo L. et al . NOTES transvaginal cholecystectomy: preliminary clinical application.  Surg Endosc. 2008;  22 542-547
    CrossrefPubMedGoogle Scholar
  • 44 McGee M F, Schomisch S J, Marks J M. et al . Late phase TNF-alpha depression in natural orifice translumenal endoscopic surgery (NOTES) peritoneoscopy.  Surgery. 2008;  143 318-328
    CrossrefPubMedGoogle Scholar
  • 45 Pham B V, Morgan K, Bazaz S. et al . A pilot comparison of adhesion formation following colonic perforation and repair in a porcine model: transgastric (NOTES), laparoscopic, or open surgical technique.  Gastrointest Endosc. 2007;  65 AB 109
    PubMedGoogle Scholar
  • 46 Wichmann M W, Hüttl T P, Winter H. et al . Immunological effects of laparoscopic vs. open colorectal surgery.  Arch Surg. 2005;  140 692-697
    CrossrefPubMedGoogle Scholar
  • 47 Buunen M, Gholghesaei M, Veldkamp R. et al . Stress response to laparoscopic surgery.  Surg Endosc. 2004;  18 1022-1028
    PubMedGoogle Scholar
  • 48 Chang C K, Zdon M J. Inflammatory response of interleukin-1beta and interleukin-6 in septic rats undergoing laparotomy and laparoscopy.  Surg Laparosc Endosc Percutan Tech. 2005;  15 124-128
    CrossrefPubMedGoogle Scholar
  • 49 Corrigan M, Cahill R, Redmond H P. (7 AD.) The immunomodulatory effects of laparoscopic surgery.  Surg Laparosc Endosc Percutan Tech. 2007;  17 256-261
    CrossrefPubMedGoogle Scholar
  • 50 Novitsky Y W, Litwin D E, Callery M P. The net immunologic advantage of laparoscopic surgery.  Surg Endosc. 2004;  18 1411-1419
    CrossrefPubMedGoogle Scholar
  • 51 Torres A, Torres K, Paszkowski T. et al . Cytokine response in the postoperative period after surgical treatment of benign adnexal masses; comparison between laparoscopy and laparotomy.  Surg Endosc. 2007;  21 1841-1848
    CrossrefPubMedGoogle Scholar
  • 52 Shimotakahara A, Kuebler J F, Vieten G. et al . Carbon dioxide directly suppresses spontaneous migration, chemotaxis, and free radical production of human neutrophils.  Surg Endosc. 2008;  22 1813-1817
    CrossrefPubMedGoogle Scholar
  • 53 Kiran R P, Delaney C P, Senagore A J. et al . Operative blood loss and use of blood products after laparoscopic and conventional open colorectal operations.  Arch Surg. 2004;  139 39-42
    CrossrefPubMedGoogle Scholar
  • 54 Gutt C N, Oniu T, Schemmer P. et al . Fewer adhesions induced by laparoscopic surgery?.  Surg Endosc. 2004;  18 898-906
    CrossrefPubMedGoogle Scholar
  • 55 Kavic S M, Kavic S M. Adhesions and adhesiolysis: the role of laparoscopy.  J Soc Laparoendosc Surg. 2002;  6 99-109
    PubMedGoogle Scholar
  • 56 Catarci M, Carlini M, Gentileschi P, Santoro E. Major and minor injuries during the creation of pneumoperitoneum. A multicenter study on 12 919 cases.  Surg Endosc. 2001;  15 566-569
    CrossrefPubMedGoogle Scholar
  • 57 Hashizume M, Sugimashi K. Needle and trocar injury during laparoscopic surgery in Japan.  Surg Endosc. 1997;  11 1198-1201
    CrossrefPubMedGoogle Scholar
  • 58 Schmedt C G, Leibl B J, Däubler P, Bittner R. Access-related complications – an analysis of 6023 consecutive laparoscopic hernia repairs.  Min Invas Ther Allied Technol. 2001;  10 23-30
    CrossrefPubMedGoogle Scholar
  • 59 Chandler J G, Corson S L, Way L W. Three spectra of laparoscopic entry access injuries.  J Am Coll Surg. 2001;  192 478-490
    CrossrefPubMedGoogle Scholar
  • 60 Kornfield E A, Sant G R, O’Leary M P. Minilaparotomy for laparoscopy: not a foolproof procedure.  J Endourol. 1994;  8 353-355
    PubMedGoogle Scholar
  • 61 Luijendijk R W, Hop W C, van den Tol M P. et al . A comparison of suture repair with mesh repair for incisional hernia.  NEJM. 2000;  343 392-398
    CrossrefPubMedGoogle Scholar
  • 62 Bittner R, Schmedt C G, Schwarz J. et al . Laparoscopic transperitoneal procedure for routine repair of groin hernias.  Br J Surg. 2002;  89 1062-1066
    CrossrefPubMedGoogle Scholar
  • 63 Bowrey D J, Blom D, Crookes P F. et al . Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication.  Surg Endosc. 2001;  15 663-666
    CrossrefPubMedGoogle Scholar
  • 64 Holzinger F, Klaiber C. [Trokarhernien: Eine seltene, potenziell gefährliche Komplikation nach laparoskopischen Eingriffen.]  Chirurg. 2002;  73 899-904
    CrossrefPubMedGoogle Scholar
  • 65 Boni L, Beneveto A, Rovera F. et al . Infective complications in laparoscopic surgery.  Surg Infect. 2006;  7 (Suppl. 2) 109-111
    PubMedGoogle Scholar
  • 66 Strickland A K, Martindale R G. The increased incidence of intraabdominal infections in laparoscopic procedures.  Surg Endosc. 2005;  19 874-881
    CrossrefPubMedGoogle Scholar
  • 67 Haricharan R N, Aprahamian C J, Morgan T L. et al . Smaller scars-what is the big deal: a survey of the perceived value of laparoscopic pyloromyotomy.  J Pediatr Surg. 2008;  43 92-96
    CrossrefPubMedGoogle Scholar

C. N. Gutt, MD

Department of General Surgery
University of Heidelberg

Im Neuenheimer Feld 110
69120 Heidelberg
Germany

Fax: +49-6221-568645

Email: carsten_gutt@med.uni-heidelberg.de

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