Department of Surgery, Sahlgrenska University Hospital - Ostra, Gothenburg, Sweden.
Endoscopy. 2010 Jan;42(1):81-4. doi: 10.1055/s-0029-1243795. Epub 2010 Jan 11.
We present a series of three patients operated on by means of natural-orifice transgastric peritoneoscopy, including one appendectomy. A standard double-lumen gastroscope was used together with standard endoscopic tools. In all patients abdominal access through the gastric wall was smooth using a needle-knife/guide-wire/balloon technique. The whole abdominal cavity could be visualized and the appendix was found in two patients. In one patient the procedure was converted to laparoscopic appendectomy and in one to open surgery. In the third patient transgastric appendectomy was performed. The gastric access site was closed with the T-tag technique. Patients were allowed to drink and eat as soon as they woke up. Postoperatively patients were followed clinically and with standard laboratory tests daily until discharged. One patient (converted to open surgery) had a serious complication (pneumothorax). The transgastric approach to the abdominal cavity was shown to be feasible, but significant technical problems remain to be resolved.
我们介绍了三例通过经自然腔道经胃腹腔镜检查进行手术的患者，其中包括一例阑尾切除术。使用标准的双腔胃镜和标准的内镜工具。在所有患者中，均使用针刀/导丝/球囊技术顺利通过胃壁进行腹部进入。整个腹腔均可见，在两名患者中发现了阑尾。在一名患者中，该手术转为腹腔镜阑尾切除术，在一名患者中转开腹手术。在第三位患者中进行了经胃阑尾切除术。使用 T 型夹技术关闭胃进入部位。患者一旦醒来即可饮水和进食。术后，患者每天均接受临床和标准实验室检查随访，直至出院。一名患者（转为开腹手术）出现严重并发症（气胸）。经胃入路进入腹腔是可行的，但仍存在需要解决的重大技术问题。
