Erschienen in:
01.09.2009 | Surgeon at work
Single-port endoscopic cholecystectomy: a bridge between laparoscopic and translumenal endoscopic surgery
verfasst von:
Nobutsugu Abe, Hirohisa Takeuchi, Hisayo Ueki, Osamu Yanagida, Tadahiko Masaki, Toshiyuki Mori, Masanori Sugiyama, Yutaka Atomi
Erschienen in:
Journal of Hepato-Biliary-Pancreatic Sciences
|
Ausgabe 5/2009
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Abstract
Background and objective
The intentional puncture of the normal viscera is likely the most important issue limiting the widespread use of natural orifice translumenal endoscopic surgery (NOTES). We developed a new procedure for cholecystectomy using a flexible endoscope via a single port placed in the abdominal wall without visceral puncture (single-port endoscopic cholecystectomy; SPEC) as a bridge between laparoscopic surgery and NOTES. This study aimed to evaluate the technical feasibility of SPEC.
Methods
Five pigs were subjected to SPEC. An endoscope was inserted through a 12-mm port placed in the right upper abdomen. After grasping and retracting the gallbladder using a 2-mm retractor that was directly introduced into the peritoneal cavity, gallbladder excision with ligation of the cystic artery and duct using endoclips was carried out.
Results
A complete gallbladder excision was carried out easily and safely in all cases. No major adverse events occurred. The mean operating time was 67 min (range 52–84 min).
Conclusions
SPEC is a technically feasible procedure. It is simpler, easier, and safer than NOTES cholecystectomy. SPEC could be a less invasive alternative to the conventional four-port laparoscopic cholecystectomy.