Bernard Dallemagne, Silvana Perretta, Pierre Allemann, Gianfranco Donatelli, Mitsuhiro Asakuma, Didier Mutter, Jacques Marescaux, Department of Digestive and Endocrine Surgery, Pôle Hépato-Digestif, University Hospital of Strasbourg and IRCAD, 67091 Strasbourg Cedex, France.
World J Gastrointest Surg. 2010 Jun 27;2(6):187-92. doi: 10.4240/wjgs.v2.i6.187.
After the first report by Kalloo et al on transgastric peritoneoscopy in pigs, it rapidly became apparent that there was no room for an under-evaluated concept and blind adoption of an appealing (r)evolution in minimal access surgery. Systematic experimental work became mandatory before any translation to the clinical setting. Choice and management of the access site, techniques of dissection, exposure, retraction and tissue approximation-sealing were the basics that needed to be evaluated before considering any surgical procedure or study of the relevance of natural orifice transluminal endoscopic surgery (NOTES). After several years of testing in experimental labs, the revolutionary concept of NOTES, is now progressively being experimented on in clinical settings. In this paper the authors analyse the challenges, limitations and solutions to assess how to move from the lab to clinical implementation of transgastric endoscopic cholecystectomy.
在 Kalloo 等人首次报道经胃腹腔镜检查术在猪身上的应用后，人们很快意识到，对于一个被低估的概念，以及对微创外科领域一项具有吸引力的（r）变革的盲目采用，是没有任何空间的。在将其转化到临床环境之前，系统的实验工作是强制性的。选择和管理进入部位、解剖、显露、牵引和组织吻合-密封等技术，是在考虑任何手术程序或研究经自然腔道内镜手术（NOTES）的相关性之前需要评估的基本内容。经过几年的实验实验室测试，NOTES 的革命性概念现在正在临床环境中逐步进行试验。在本文中，作者分析了评估如何从实验室过渡到经胃内镜胆囊切除术的临床实施的挑战、局限性和解决方案。
