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Journal of the Korean Society of Coloproctology 2007;23(6):397-402.
DOI: https://doi.org/10.3393/jksc.2007.23.6.397   
Transgastric Gastroscopic Intra-abdominal Exploration in a Female Dog Model: NOTES (Natural Orifice Transluminal Endoscopic Surgery).
Kim, Young Ill , Park, Jong Heon , Lee, Sang Ill , Jeong, Seong Mok , Kim, Ji Yeon
1ChungCheong Surgical Clinic, Daejeon, Korea.
2Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea. jykim@cnuh.co.kr
3Department of Veterinary Surgery, Chungnam National University College of Veterinary Medicine, Daejeon, Korea.
Abstract
PURPOSE
Natural orifice transluminal endoscopic surgery (NOTES) is a new surgical option using endoscopic advancement to the peritoneal cavity through the stomach, colon, vagina, or urinary bladder without an abdominal wall scar (incision). The aim of this study was to assess the feasibility of transgastric gastroscopic intra-abdominal exploration with gastric incision and closure before the NOTES would be done.
METHODS
Under general anesthesia of a female dog, one-channel gastroscope was advanced to the stomach and the lumen was irrigated with anti-bacterial solution. The anterior wall of the antrum was incised by about 1 cm with a needle knife; then, the gastroscope was advanced into the peritoneal cavity. An exploration of the entire intra-abdominal cavity was performed.
RESULTS
We were able to evaluate the stomach, the greater omentum, the diaphragm, the peritoneum, the urinary bladder, the bowel, the spleen, the liver, the gallbladder, the uterine horn, the uterine body, and the vagina, but could not evaluate the ovary, the kidney, and the pancreas. The observation of the abdominal cavity was followed by the gastric wall closure with a 135o endoclip. The dog was recovered after confirmation of secure closure of the incision site.
CONCLUSIONS
Transgastric incision, closure, and abdominal exploration are feasible without an abdominal wall scar, and the NOTES can be one option for future abdominal operations in humans and needs to be further investigated.
Key Words: NOTES; Transgastric gastroscopic intra-abdominal exploration
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