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Transvesical thoracoscopy: a natural orifice translumenal endoscopic approach for thoracic surgery

Title
Transvesical thoracoscopy: a natural orifice translumenal endoscopic approach for thoracic surgery
Type
Article in International Scientific Journal
Year
2007
Authors
Lima, E
(Author)
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Henriques-Coelho, T
(Author)
FMUP
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Rolanda, C
(Author)
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Pêgo, JM
(Author)
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Silva, D
(Author)
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Carvalho, JL
(Author)
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Correia-Pinto, J
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Journal
Vol. 21 No. 6
Pages: 854-858
ISSN: 0930-2794
Publisher: Springer
Indexing
Pubmed / Medline
Scientific classification
FOS: Medical and Health sciences
Other information
Abstract (EN): BACKGROUND: Recently there has been an increasing enthusiasm for using natural orifices translumenal endoscopic surgery (NOTES) to perform scarless abdominal procedures. We have previously reported the feasibility and safety of the transvesical endoscopic peritoneoscopy in a long-term survival porcine model as useful for those purposes. Herein, we report our successful experience performing transvesical and transdiaphragmatic endoscopic approach to the thoracic cavity in a long-term survival study in a porcine model. METHODS: Transvesical and transdiaphragmatic endoscopic thoracoscopy was performed in six anesthetized female pigs. A 5 mm transvesical port was created on the bladder wall and an ureteroscope was advanced into the peritoneal cavity. After diaphragm inspection, we introduced through the left diaphragmatic dome a ureteroscope into the left thoracic cavity. In all animals, we performed thoracoscopy as well as peripheral lung biopsy. Animals were sacrificed by day 15 postoperatively. RESULTS: We easily introduced a 9.8 Fr ureteroscope into the thoracic cavity that allowed us to visualize the pleural cavity and to perform simple surgical procedures such as lung biopsies without complications. There were neither respiratory distress episodes nor surgical complications to report. Postmortem examination revealed complete healing of vesical and diaphragmatic holes, whereas no signs of infection or adhesions were observed in the peritoneal or thoracic cavities. CONCLUSION: This study demonstrates the feasibility of transvesical thoracoscopy in porcine model. However, although this study extends the potential applications of NOTES to the thoracic cavity, new instruments and further work are needed to provide evidence that this could be translated to humans and with advantages for patients.
Language: English
Type (Professor's evaluation): Scientific
License type: Click to view license CC BY-NC
Documents
File name Description Size
10.1007_s00464-007-9366-x 256.59 KB
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