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transgastricappendectomy in
humans in India By Dr. G V Rao
and Dr. N Reddy. (Hyderabad,
India)
NOTES: HISTORY
Since then, multiple investigators
have used transluminal
endoscopy
in animal models to perform
various intraperitoneal surgical
procedures, ranging from tubal
ligation to splenectomy.
NOTES: THE IDEA
Idea of NOTES-developed in response to facts that
patients would-
1) realize the benefits of this least invasive
technique of surgery.
potentially
less complications,
but only possible in women.
De-merits of NOTES
It is very important that the closure device and
Abstract
Aim
Natural orifice transluminal endoscopic surgery (NOTES)
is currently a very important topic for surgeons.
The median age of the patients was 48 years (range, 36–60) and the
median body mass index was 23.6 (range, 20.4–25.3).
The median tumor size was 6 cm (range, 3.7–6.7). The median
operative time was 45 min (range, 40–80).
The estimated blood loss was minimal (range, 5–300 mL). The
median postoperative hospital stay was 2 days (range, 1–3).
All the patients were very satisfied with the cosmetic result.
Conclusion
Objective
To summarize and critically analyze the available
evidence on the current status and future perspectives
of LESS and NOTES in urology.
Evidence acquisition
A comprehensive electronic literature search was conducted in
June 2010 using the Medline database to identify all
publications relating to NOTES and LESS in urology.
Evidence synthesis
In urology, NOTES has been completed experimentally via
transgastric,
transvaginal,
transcolonic, and
transvesical routes.
Initial clinical experience has shown that NOTES urologic surgery
using currently available instruments is indeed possible.
Nevertheless, because of the immaturity of the
instrumentation, early cases have demanded high
technical virtuosity.
Disadvantages
Disadvantages
Disadvantages
Disadvantages
Abstract
BACKGROUND:
The aim of the present study was to compare the
clinical and cosmetic results of transvaginal hybrid
cholecystectomy (TVC), single-port
cholecystectomy (SPC), and conventional
laparoscopic cholecystectomy (CLC).
Recently, single-incision laparoscopic surgery
and natural orifice transluminal endoscopic
surgery have been developed as minimally
invasive alternatives for CLC. Few comparative
studies have been reported
Methods:
Female patients with symptomatic gallstone
disease who were treated in 2011 with SPC,
TVC, or CLC were entered into a database.
Patients were matched for age, body mass
index, and previous abdominal surgery.
After the operation all patients received a
survey with questions about recovery,
cosmesis, and body image.
Results:
total of 90 patients, 30 in each group, were evaluated.
Median operative time for CLC was significantly shorter
(p < 0.001).
There were no major complications.
Length of hospital stay, postoperative pain, and
postoperative complications were not significantly
different.
The results for cosmesis and body image after the
transvaginal approach were significantly higher.
None of the sexually active women observed
postoperative dyspareunia
Conclusions:
Both SPC and TVC are feasible procedures when
performed in selected patients.