Moyer Matthew T, Pauli Eric M, Haluck Randy S, Mathew Abraham
Division of Gastroenterology/Hepatology, Penn State Hershey Medical Center, Hershey, PA 17033, USA.
Gastrointest Endosc. 2007 Nov;66(5):974-8. doi: 10.1016/j.gie.2007.03.1050. Epub 2007 Sep 27.
NOTES (natural orifice transluminal endoscopic surgery) is an area of active research in experimental endoscopy and has the potential to significantly advance the field of minimally invasive surgery. Several investigators have illustrated the need for a transluminal access technique that is safe, reliable, and reproducible. Currently used methods directly cut through the organ wall into the peritoneum; however, rare difficulty in closing the defect with negative outcomes have been described.
To evaluate an alternative method for transluminal access.
An ex vivo, experimental endoscopy study.
Penn State Hershey Medical Center, Animal Research Laboratories.
By using ex vivo porcine esophagus, stomach, and colon, a submucosal tunnel was created as a means of physically separating the lumen from the peritoneum during transluminal access. Postprocedure leak testing was performed, and all procedures were video recorded.
Results of the self-approximating transluminal access technique (STAT) in porcine esophagus and stomach demonstrated the technical feasibility of this approach. The STAT was not felt to be feasible in the porcine colon.
This investigation was a limited, ex vivo pilot study and will require further testing in an adequate number of live animals.
The STAT is technically feasible in porcine esophagus and stomach, and may have advantages over currently used techniques.
NOTES（经自然腔道内镜手术）是实验性内镜领域的一个活跃研究方向，有潜力显著推动微创手术领域的发展。一些研究人员已阐明需要一种安全、可靠且可重复的经腔道进入技术。目前使用的方法是直接穿过器官壁进入腹膜腔；然而，已报道了在闭合缺损时罕见的困难及不良后果。
评估一种经腔道进入的替代方法。
一项离体实验性内镜研究。
宾夕法尼亚州立大学赫尔希医学中心动物研究实验室。
利用离体猪食管、胃和结肠，创建一个黏膜下隧道，作为经腔道进入时将管腔与腹膜腔物理分隔的一种手段。术后进行渗漏测试，并对所有操作进行视频记录。
猪食管和胃的自近似经腔道进入技术（STAT）的结果证明了该方法在技术上的可行性。STAT在猪结肠中被认为不可行。
本研究是一项有限的离体初步研究，需要在足够数量的活体动物中进行进一步测试。
STAT在猪食管和胃中技术上可行，可能比目前使用的技术具有优势。
