Surgical videos in NOTES

Background and study aims: It is generally accepted that the most effective method of treating achalasia is a surgical myotomy. Nevertheless, if a myotomy alone is performed, reflux may occur in up to 50% of patients. This video demonstrates a transoral incisionless stepwise approach to both ...

Optical coherence tomography (OCT) is capable of 2–3mm slicing in opaque samples and so provides real-time cross-sectional images from the specimen. OCT can also achieve resolutions approaching that of conventional histology (c. 2–5μm) as it employs very short wave near-infrared light with ...

NOTES may provide for full-thickness localised excision of early stage colon neoplasia. This may potentially be curative if the lesion could also be proven node negative. Here we demonstrate how such a procedure could be linked with a sentinel node biopsy also being performed by NOTES so that the ...

Lymphatic mapping and sentinel node biopsy could perhaps allow accurate nodal staging as complement to endoscopic submucosal resection of early primary neoplasia. Here we demonstrate how this technique could be performed by a NOTES approach as an oncological supplement to the intraluminal resective ...

After demonstrating the feasibility of NOTES rectosigmoid resection using TEM with endoscopic assistance in swines in her pilot study published in the Journal of Gastrointestinal Surgery in August 2008, Dr. Patricia Sylla has come to the IRCAD to demonstrate her technique in doing a TEM ...

In this video, we show a representative example of NOTES cholecystectomy by transgastric and transvesical combined approach, in which feasibility was demonstrated in 7 female pigs. Thus, transgastric access was achieved after perforation and dilatation of the gastric wall with a needle knife and ...

This video demonstrates fully how NOTES can facilitate 'cherry-picking' of sentinel nodes from the perigastric lymph basins (including the retropyloric space) after gastroscopic lymphatic mapping of a site in the stomach in an experimental model. It is proposed that this could be partnered with ...

This video demonstrates a number of different NOTES techniques for performing sigmoidectomy in a porcine model. The principal trans-gastric approach is combined with a trans-vaginal, trans-rectal and laparoscopic approach in 3 different animals. Different methods of vascular dissection and colonic ...

In this video, a technique for the creation and closure of a gastrostomy to facilitate transgastric peritoneoscopy is demonstrated. It includes discussion of all the key steps of the procedure.

This video shows the formatting of gastric sleeve surgery via a hybrid NOTES technique in a porcine model. A transvaginal approach is used along with one single transabdominal trocar with additional retraction aided by both an intraluminal gastroscope and an intragastric magnet (anchored by a ...

This video demonstrates the stepwise technique for performing a one trocar sleeve gastrectomy in a porcine model. The procedure is achieved through the air-seal device (which functions as a single trocar and insufflation system at the same time) and with the aid of different length instruments ...

This video shows the technique of a NOTES hybrid sleeve gastrectomy performed live during the NOTES course. The intra-abdominal access is made via a transvaginal approach (double channel KARL STORZ endoscope and one grasper) combined with one abdominal trocar. The main steps of the procedure are ...

This video displays the creation and closure of a gastrotomy for any transgastric approach step by step. It also illustrates a clever way to maintain the pneumogastrium. This video details the main obstacles and achievements so far in determining the safety and efficacy of both gastric access and ...

This video demonstrates the transvaginal approach to the retroperitoneal space.
A posterior colpotomy is carried out with the needle-knife. The retroperitoneal space is entered digitally enlarging the posterior vaginal incision. In order to avoid peritoneal entering, precise identification of key ...

This video shows how to perform nephrectomy in the porcine model with a novel transvaginal retroperitoneal NOTES technique.
Conceivably, nephrectomy performed through a natural orifice could enhance cosmesis and minimize postoperative recovery. The vagina has been considered a viable route for ...

This video fully demonstrates all the technical aspects of performing sentinel node biopsy in the sigmoid mesocolon by NOTES. A transgastric access to the peritoneum allows a flexible gastroscope observe the lymphatic mapping in real-time and then to perform excisional nodal biopsy while magnetic ...

Misinterpretation of normal anatomy and anatomical variations contribute to the occurrence of major complications like biliary injury during cholecystectomy. Performing a NOTES transgastric cholecystectomy under endoscopic view, whenever the anatomy of the biliary tract is confusing as happened in ...

Under general anesthesia with the patient supine in lithotomy position, a pelvic exam is performed. A first 5mm umbilical trocar is placed and an exploratory laparoscopy is performed to ascertain the feasibility of a NOTES cholecystectomy. The patient is then tilted in steep Trendelenburg. The ...

Natural orifice transluminal endoscopic surgery (NOTES) is an emerging field in minimally invasive surgery that is driving the development of new technology and techniques. There are several benefits of the NOTES approach, decreased abdominal pain, wound infections, and hernia formation. This video ...

Laparoscopic splenectomy (LS) has become the gold standard approach for normal spleens. Natural Orifice Transluminal Endoscopic Surgery (NOTES) has been used for transgastric splenectomy in the experimental setting, but there is no information about the application of NOTES or hybrid NOTES in ...

Laparoscopic sleeve gastrectomy is a relatively new procedure, which is gaining popularity for the treatment of morbid obesity. In this live video demonstration from the March 2009 NOTES Advanced Course at IRCAD in Strasbourg, Dr. Michel Vix performs a hybrid natural orifice transluminal endoscopic ...

This video shows the first totally NOTES cholecystectomy via a transvaginal approach in a 30-year-old woman with symptomatic cholelithiasis. The operation was performed by a multidisciplinary team, which included a gynecologist who performed and closed the colpotomy. The peritoneal cavity was ...

This video shows a stepwise approach for a NOTES transvaginal cholecystectomy. The advantages of the hybrid technique are approached.

This video shows live interviews with leading experts in NOTES during a hands-on NOTES masterclass held at the IRCAD's experimental laboratory last October 4, 2008.

This recording of a masterclass in NOTES held at the IRCAD (2nd International NOTES hands-On Course, October 12-13, 2007) demonstrates the salient steps of several NOTES operations performed simultaneously and includes the comments of a live audience and input from expert observers. The 'PEG' ...