Safe alternative transgastric peritoneal access in humans: NOTES

Surgery
Peter N NauJeffrey W Hazey

Abstract

Diagnostic transgastric endoscopic peritoneoscopy has been used to evaluate the abdomen. We present our experience with transgastric endoscopic peritoneoscopy (TEP) to access the peritoneum, direct trocar placement, and perform adhesiolysis without laparoscopic visualization in patients undergoing laparoscopic Roux-en-Y gastric bypass. Forty patients participated. There are 2 arms to the study. The initial 20 patients underwent pre-insufflation of the abdomen prior to TEP. The second 20 had no pre-insufflation. Ten patients in each arm had no surgical history. The other 10 had previous intra-abdominal procedures. TEP was performed through a gastrotomy created without laparoscopic visualization. Adhesions were visualized and taken down endoscopically prior to trocar placement. Diagnostic findings, operative times, and clinical course were recorded. Average TEP time was 19 min. Three patients had limited visualization due to intra-abdominal adhesions (2) and omental fat (1). Three of the 20 without and 17 of 20 with a history of intra-abdominal surgery had adhesions visualized endoscopically. Endoscopic adhesiolysis was performed in 1 and 4 patients in these groups respectively. Six occult umbilical hernias, 1 inguinal hernia, an...Continue Reading

References

Feb 27, 2007·Gastrointestinal Endoscopy·Sergey V KantsevoyAnthony N Kalloo
Aug 19, 2007·Surgical Endoscopy·Jeffrey W HazeyW Scott Melvin
Nov 21, 2007·Surgical Endoscopy·Vimal K NarulaW Scott Melvin
Nov 21, 2007·Surgical Endoscopy·R ZorronM Filgueiras
May 28, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Antonello ForgioneRaffaele Pugliese
Jul 9, 2008·Endoscopy·A Cardoso RamosY Moyses
Apr 4, 2009·Surgical Endoscopy·Luiz Henrique de SousaRicardo Zorron

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Citations

Apr 13, 2011·World Journal of Gastroenterology : WJG·Byron F Santos, Eric S Hungness
Oct 27, 2010·Surgical Endoscopy·Peter NauJeffrey W Hazey
Feb 24, 2012·Internal Medicine Journal·V Kwan
Aug 24, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Liu LiuUNKNOWN APNOTES Working Group
Dec 31, 2011·American Journal of Surgery·Demetrios N MorisAlexandros E Papalampros
Sep 7, 2011·Nature Reviews. Gastroenterology & Hepatology·Mouen A Khashab, Anthony N Kalloo

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