BACKGROUND: A few studies have addressed the physiology related to a basic natural-orifice transluminal endoscopy surgery (NOTES) procedure, such as transgastric peritoneoscopy, but the physiologic impact of more complex NOTES procedures has not been previously examined. OBJECTIVE: To evaluate the cardiopulmonary and immunologic effects of transvaginal NOTES cholecystectomy compared with laparoscopic cholecystectomy. SETTING: Survival experiments in 10 40-kg female pigs assigned to transvaginal cholecystectomy and laparoscopic cholecystectomy groups. INTERVENTIONS: Transvaginal cholecystectomy was performed with the assistance of a needlescopic device, and laparoscopic cholecystectomy was performed in the standard manner. MAIN OUTCOME MEASUREMENTS: Cardiopulmonary and immunologic parameters in the transvaginal cholecystectomy group were compared with those in the laparoscopic cholecystectomy group. Cardiopulmonary parameters included heart rate, blood pressure, saturation pulse oximetry, intratracheal pressure, and arterial blood gases. Immunologic parameters included white blood cell count, tumor necrosis factor-α, interleukin-1β, and interleukin-6. RESULTS: All procedures were performed successfully without complications. Although operation times were longer for transvaginal cholecystectomy than for laparoscopic surgery, cardiopulmonary changes were similar and stable in both groups. White blood cell count, interleukin-1β, and interleukin-6 did not differ between the 2 groups, and the increase in tumor necrosis factor α after transvaginal cholecystectomy was significantly smaller on postoperative day 1 than after laparoscopic cholecystectomy (133.4 pg/mL vs 200.4 pg/mL; P < .05). LIMITATIONS: Animal model and small sample size. CONCLUSIONS: Transvaginal cholecystectomy resulted in cardiopulmonary stability and well preserved immune function similar to those of laparoscopic cholecystectomy, suggesting that NOTES may be less invasive than laparoscopic surgery.
BACKGROUND: A few studies have addressed the physiology related to a basic natural-orifice transluminal endoscopy surgery (NOTES) procedure, such as transgastric peritoneoscopy, but the physiologic impact of more complex NOTES procedures has not been previously examined. OBJECTIVE: To evaluate the cardiopulmonary and immunologic effects of transvaginal NOTES cholecystectomy compared with laparoscopic cholecystectomy. SETTING: Survival experiments in 10 40-kg female pigs assigned to transvaginal cholecystectomy and laparoscopic cholecystectomy groups. INTERVENTIONS: Transvaginal cholecystectomy was performed with the assistance of a needlescopic device, and laparoscopic cholecystectomy was performed in the standard manner. MAIN OUTCOME MEASUREMENTS: Cardiopulmonary and immunologic parameters in the transvaginal cholecystectomy group were compared with those in the laparoscopic cholecystectomy group. Cardiopulmonary parameters included heart rate, blood pressure, saturation pulse oximetry, intratracheal pressure, and arterial blood gases. Immunologic parameters included white blood cell count, tumor necrosis factor-α, interleukin-1β, and interleukin-6. RESULTS: All procedures were performed successfully without complications. Although operation times were longer for transvaginal cholecystectomy than for laparoscopic surgery, cardiopulmonary changes were similar and stable in both groups. White blood cell count, interleukin-1β, and interleukin-6 did not differ between the 2 groups, and the increase in tumor necrosis factor α after transvaginal cholecystectomy was significantly smaller on postoperative day 1 than after laparoscopic cholecystectomy (133.4 pg/mL vs 200.4 pg/mL; P < .05). LIMITATIONS: Animal model and small sample size. CONCLUSIONS: Transvaginal cholecystectomy resulted in cardiopulmonary stability and well preserved immune function similar to those of laparoscopic cholecystectomy, suggesting that NOTES may be less invasive than laparoscopic surgery.
Authors: Josiel P Vieira; Marcelo M Linhares; Elesiário M Caetano; Rita M A Moura; Vitor Asseituno; Rogério Fuzyi; Manoel J B Girão; José M Ruano; Alberto Goldenberg; Gaspar de Jesus L Filho; Délcio Matos Journal: Surg Endosc Date: 2012-06-23 Impact factor: 4.584
Authors: Carlos Guarner-Argente; Graciela Martínez-Pallí; Ricard Navarro-Ripoll; Henry Córdova; Mireia Beltrán; M Angels Martínez-Zamora; Jaume Comas; Cristina Rodríguez de Miguel; Antonio Rodríguez-D'Jesús; Xavier Filella; Clara Hernández-Cera; Antonio M Lacy; Christopher C Thompson; Gloria Fernández-Esparrach Journal: Surg Endosc Date: 2011-09-05 Impact factor: 4.584
Authors: Dirk Rolf Bulian; Linda Trump; Jürgen Knuth; Robert Siegel; Axel Sauerwald; Michael A Ströhlein; Markus Maria Heiss Journal: Surg Endosc Date: 2012-08-28 Impact factor: 4.584