Methodist Hospital Institute for Kidney Stone Disease, Indianapolis, Indiana 46202, USA.
J Endourol. 2010 Sep;24(9):1493-6. doi: 10.1089/end.2009.0276.
The goal of this study is to demonstrate the feasibility of transurethral radical prostatectomy in the canine model. We describe the surgical procedure for natural orifice translumenal endoscopic surgery-radical prostatectomy (NOTES-RP).
NOTES-RP was performed on six nonsurvival male canines. The 100 watt holmium:yttrium-aluminum-garne laser, 550 μm end-firing fiber, 28F laser resectoscope, 7F stabilizing catheter, and continuous irrigation were used to radically resect the prostate. A Vest vesicourethral anastomosis was performed using a laparoscopic suture device that was delivered through the nephroscope. In the initial cases, the prostate was removed manually; for the last two cases, the prostate was removed endoscopically with a tissue morcellator.
NOTES-RP was successfully executed in all canines. Visualization was not obscured by bleeding. Dissection times ranged from 40 to 120 minutes. Fluid absorption was problematic in cases lasting more than 1 hour, because of the intraperitoneal location of the canine prostate and bladder.
The feasibility and technique of NOTES-RP was successfully demonstrated in the living canine model.
本研究旨在展示犬模型中经尿道根治性前列腺切除术的可行性。我们描述了经自然腔道内镜手术-根治性前列腺切除术（NOTES-RP）的手术步骤。
对 6 只非存活雄性犬进行 NOTES-RP。使用 100 瓦特钬：钇-铝-石榴石激光、550μm 端射纤维、28F 激光切除术镜、7F 稳定导管和持续灌洗来彻底切除前列腺。使用通过肾镜输送的腹腔镜缝合装置进行 Vest 膀胱尿道吻合术。在最初的几个病例中，手动切除前列腺；对于后两个病例，使用组织捣碎器在内窥镜下切除前列腺。
所有犬均成功完成 NOTES-RP。无出血导致的视野遮挡。解剖时间从 40 分钟到 120 分钟不等。由于犬前列腺和膀胱的腹腔内位置，如果手术持续超过 1 小时，会出现液体吸收问题。
活体犬模型中成功证明了 NOTES-RP 的可行性和技术。
