Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
Department of Gastroenterology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
World J Gastroenterol. 2022 May 21;28(19):2112-2122. doi: 10.3748/wjg.v28.i19.2112.
Natural orifice transluminal endoscopic surgery (NOTES) gallbladder-preserving surgery by flexible endoscopy is an emerging technology. However, the gallbladder fails to obtain traction and positioning functions during the operation.
To evaluate the feasibility and safety of a new surgical method, "snare-assisted pure NOTES gallbladder-preserving surgery".
Eight miniature pigs were randomly divided into the experimental group [NOTES gallbladder-preserving surgery using the snare device, snare assisted (SA)] and the control group (NOTES gallbladder-preserving surgery without using the snare device, NC), with four cases in each group. The differences between the two groups of animals in operating time, operating workload, complications, adverse events, white blood cells, and liver function were determined.
No differences were found in the surgical success rate, gallbladder incision closure, white blood cell count, or liver function between the two groups. The total operating time, gallbladder incision blood loss, gallbladder disorientation time, gallbladder incision closure time, and workload scores on the National Aeronautics and Space Administration-Task Load Index were significantly reduced in the SA group ( < 0.05).
These results indicated that snare-assisted pure NOTES gallbladder-preservation surgery using standard endoscopic instruments reduced the difficulty of operation, shortened operation time, and did not increase complications in pigs. A new method for pure NOTES gallbladder-preservation surgery was provided.
经自然腔道内镜手术（NOTES）的软性内镜保胆手术是一种新兴技术。然而，在手术过程中胆囊无法获得牵引和定位功能。
评估一种新的手术方法“圈套器辅助纯NOTES 保胆手术”的可行性和安全性。
将 8 只小型猪随机分为实验组[使用圈套器的NOTES 保胆手术，圈套器辅助（SA）]和对照组（未使用圈套器的NOTES 保胆手术，NC），每组 4 只。比较两组动物在手术时间、手术工作量、并发症、不良事件、白细胞和肝功能方面的差异。
两组动物的手术成功率、胆囊切口闭合、白细胞计数或肝功能无差异。SA 组的总手术时间、胆囊切口出血量、胆囊定向时间、胆囊切口闭合时间和美国国家航空航天局-任务负荷指数（NASA-Task Load Index）的工作量评分均显著降低（<0.05）。
这些结果表明，使用标准内镜器械进行圈套器辅助纯 NOTES 保胆手术可降低手术难度、缩短手术时间，且不会增加猪的并发症。为纯 NOTES 保胆手术提供了一种新方法。
