BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES) is the newest technique emerging in the field of surgery. There are several techniques described in the literature, though there is no standardization yet. In this paper, we describe a transumbilical approach for the endoscopic appendectomy in humans. MATERIALS AND METHODS: Eight of 12 patients with uncomplicated appendicitis successfully underwent a transumbilical endoscopic appendectomy. Patients with a mass, abscessed or perforated appendix, previous lower abdominal surgeries, and conversion to laparoscopy (4 patients) were excluded. RESULTS: The average age of the patients was 32.5 years. The mean operating time was 95 minutes, and the conversion rate was 33.3%. Only 1 dose of intravenous analgesics was administered postoperatively. Hospital stay was 1-3 days. The follow-ups were scheduled at 7, 30, and 90 days and 8 months. Six patients completed all the follow-ups and experienced no problems. DISCUSSION: So far, this transumbilical approach to the appendectomy in humans has not been reported. We think that this method of approach is an effective technique by itself and an ideal "stepping stone" to NOTES, as well as helpful to train laparoscopic surgeons to make the transition to full-fledged NOTES. Unlike the transgastric or transvaginal approaches, the umbilical approach allows an easy maneuverability of the endoscope, though at the cost of an umbilical scar. The technical ease of the procedure and early outcome seem satisfactory. This technique may be considered as a "precursor" to NOTES.
BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES) is the newest technique emerging in the field of surgery. There are several techniques described in the literature, though there is no standardization yet. In this paper, we describe a transumbilical approach for the endoscopic appendectomy in humans. MATERIALS AND METHODS: Eight of 12 patients with uncomplicated appendicitis successfully underwent a transumbilical endoscopic appendectomy. Patients with a mass, abscessed or perforated appendix, previous lower abdominal surgeries, and conversion to laparoscopy (4 patients) were excluded. RESULTS: The average age of the patients was 32.5 years. The mean operating time was 95 minutes, and the conversion rate was 33.3%. Only 1 dose of intravenous analgesics was administered postoperatively. Hospital stay was 1-3 days. The follow-ups were scheduled at 7, 30, and 90 days and 8 months. Six patients completed all the follow-ups and experienced no problems. DISCUSSION: So far, this transumbilical approach to the appendectomy in humans has not been reported. We think that this method of approach is an effective technique by itself and an ideal "stepping stone" to NOTES, as well as helpful to train laparoscopic surgeons to make the transition to full-fledged NOTES. Unlike the transgastric or transvaginal approaches, the umbilical approach allows an easy maneuverability of the endoscope, though at the cost of an umbilical scar. The technical ease of the procedure and early outcome seem satisfactory. This technique may be considered as a "precursor" to NOTES.
Authors: Kamran Ahmed; Tim T Wang; Vanash M Patel; Kamal Nagpal; James Clark; Mariam Ali; Samer Deeba; Hutan Ashrafian; Ara Darzi; Thanos Athanasiou; Paraskevas Paraskeva Journal: Surg Endosc Date: 2010-07-10 Impact factor: 4.584
Authors: Chung-Heon Lee; Won Joong Jeon; Sei Jin Youn; Hyo Young Yun; Lee-Chan Jang; Jae-Woon Choi; Young Jin Song; Dong Hee Ryu Journal: Ann Surg Treat Res Date: 2014-04-24 Impact factor: 1.859
Authors: Haythem Najah; Réa Lo Dico; Marion Grienay; Anthony Dohan; Xavier Dray; Marc Pocard Journal: Surg Endosc Date: 2015-12-10 Impact factor: 4.584
Authors: Alberto Arezzo; Carsten Zornig; Hamid Mofid; Karl-Hermann Fuchs; Wolfram Breithaupt; José Noguera; Georg Kaehler; Richard Magdeburg; Silvana Perretta; Bernard Dallemagne; Jacques Marescaux; Catalin Copaescu; Florin Graur; Andrei Szasz; Antonello Forgione; Raffaele Pugliese; Gerhard Buess; Hemanga K Bhattacharjee; Giuseppe Navarra; Mario Godina; Kirill Shishin; Mario Morino Journal: Surg Endosc Date: 2013-03-22 Impact factor: 4.584