Bessler Marc, Stevens Peter D, Milone Luca, Hogle Nancy J, Durak Evren, Fowler Dennis
Department of Surgery, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, Suite 620, New York, NY 10032, USA.
Surg Endosc. 2008 Jul;22(7):1715-6. doi: 10.1007/s00464-008-9779-1. Epub 2008 Mar 6.
Natural orifice transluminal endoscopic surgery (NOTES) is considered the new frontier for minimally invasive surgery. NOTES procedures such as peritoneoscopy, splenectomy, and cholecystectomy in animal models have been described. The aim of our experiment was to determine the feasibility and technical aspects of a new endoluminal surgical procedure. After approval from Columbia's IACUC, a transvaginal laparoscopically assisted endoscopic cholecystectomy was performed on four 30 kg Yorkshire pigs. The first step was to insert a 1.5 cm endoscope into the vagina under direct laparoscopic vision. Then the gallbladder was reached and, with the help of a laparoscopic grasper to hold up the gallbladder, the operation was performed. At the end of the procedure the gallbladder was snared out through the vagina attached to the endoscope. There were no intraoperative complications such as bleeding, common bile duct or endo-abdominal organ damage. Total operative time ranged between 110 and 155 min. Based on our experience in the porcine model, we believe that a transvaginal endoscopic cholecystectomy is feasible in humans.
经自然腔道内镜手术（NOTES）被认为是微创手术的新前沿。动物模型中的NOTES手术，如腹腔镜检查、脾切除术和胆囊切除术已有相关描述。我们实验的目的是确定一种新的腔内手术方法的可行性和技术要点。在获得哥伦比亚大学实验动物护理与使用委员会（IACUC）的批准后，对4只30千克的约克夏猪进行了经阴道腹腔镜辅助内镜胆囊切除术。第一步是在腹腔镜直视下将一根1.5厘米的内窥镜插入阴道。然后找到胆囊，在腹腔镜抓钳托起胆囊的帮助下进行手术。手术结束时，将胆囊通过与内窥镜相连的阴道圈套取出。术中没有出现出血、胆总管或腹腔内器官损伤等并发症。总手术时间在110至155分钟之间。基于我们在猪模型中的经验，我们认为经阴道内镜胆囊切除术在人体中是可行的。
