The Experts below are selected from a list of 249 Experts worldwide ranked by ideXlab platform
Christopher J Gostout - One of the best experts on this subject based on the ideXlab platform.
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techniques for transgastric access to the Peritoneal Cavity
Gastrointestinal Endoscopy Clinics of North America, 2008Co-Authors: Kazuki Sumiyama, Christopher J GostoutAbstract:Natural orifice translumenal endoscopic surgery (NOTES) is a unique emerging surgical concept expanding flexible endoscopy beyond the gut wall. The methods and technology growing from this concept may minimize trauma from surgical access to the Peritoneal Cavity by completely eliminating body surface incisions. So far, NOTES surgeries have been reported by modifying laparoscopic surgery. The peroral transgastric route was chosen to access the Peritoneal Cavity in initial trials because of a potentially lower risk for surrounding organ injury using the anterior wall percutaneous endoscopic gastrostomy–style gastrotomy. This article reviews and describes techniques of transgastric access to the Peritoneal Cavity used in published animal studies.
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preliminary pneumoperitoneum facilitates transgastric access into the Peritoneal Cavity for natural orifice transluminal endoscopic surgery a pilot study in a live porcine model
Endoscopy, 2007Co-Authors: Chungwang Ko, Christopher J Gostout, Sydney S C Chung, Peter B Cotton, Eun Ji Shin, Jonathan M Buscaglia, John O Clarke, Priscilla Magno, Samuel A Giday, Robert H HawesAbstract:BACKGROUND AND STUDY AIMS: Safe entrance into the Peritoneal Cavity through the gastric wall is paramount for the successful clinical introduction of natural orifice transluminal endoscopic surgery (NOTES). The aim of the study was to develop alternative safe transgastric access to the Peritoneal Cavity. PATIENTS AND METHODS: We performed 11 survival experiments on 50-kg pigs. In sterile conditions, the abdominal wall was punctured with a Veress needle. The Peritoneal Cavity was insufflated with 2 L carbon dioxide (CO 2 ). A sterile endoscope was introduced into the stomach through a sterile overtube; the gastric wall was punctured with a needle-knife; after balloon dilation of the puncture site, the endoscope was advanced into the Peritoneal Cavity. Peritoneoscopy with biopsies from abdominal wall, liver and omentum, was performed. The endoscope was withdrawn into the stomach. The animals were kept alive for 2 weeks and repeat endoscopy was followed by necropsy. RESULTS: The pneumoperitoneum, easily created with the Veress needle, lifted the abdominal wall and made a CO 2 -filled space between the stomach and adjacent organs, facilitating gastric wall puncture and advancement of the endoscope into the Peritoneal Cavity. There were no hemodynamic changes or immediate or delayed complications related to pneumoperitoneum, transgastric access, or intraPeritoneal manipulations. Follow-up endoscopy and necropsy revealed no problems or complications inside the stomach or Peritoneal Cavity. CONCLUSIONS: Creation of a preliminary pneumoperitoneum with a Veress needle facilitates gastric wall puncture and entrance into the Peritoneal Cavity without injury to adjacent organs, and can improve the safety of NOTES.
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a novel safe approach to the Peritoneal Cavity for per oral transgastric endoscopic procedures
Gastrointestinal Endoscopy, 2007Co-Authors: Sergey V Kantsevoy, Christopher J Gostout, Sanjay B Jagannath, Hideaki Niiyama, Nina V Isakovich, Sydney S C Chung, Peter B Cotton, Robert H Hawes, Pankaj J Pasricha, Anthony N KallooAbstract:Background We have previously reported the feasibility and safety of per-oral transgastric endoscopic procedures in a porcine model. Objective Our purpose was to evaluate the safety and feasibility of a PEG-like approach to the Peritoneal Cavity. Settings Acute experiments on 50-kg pigs under general anesthesia. Design and Interventions After per-oral intubation, the endoscope was positioned into the body of the stomach, the anterior abdominal wall was transilluminated and punctured with a needle, and a guidewire was inserted into the stomach through the needle. The guidewire was grasped with endoscopic forceps and pulled through the biopsy channel of the endoscope. A sphincterotome was inserted into the gastric wall over the guidewire. Gastric incision was performed and the endoscope was advanced into the Peritoneal Cavity. The Peritoneal Cavity was insufflated and endoscopic peritoneoscopy was performed. Then the animal was euthanized and necropsy was performed. Main Outcome Measures Safety of transgastric entrance to Peritoneal Cavity. Results The PEG-like approach was used in 12 pigs. The average procedure time was 11.4 ± 3.7 minutes. There was only 1 complication related to the access: bleeding from the gastric wall incision was documented when a pure cut (without coagulation) current was used for incision of the gastric wall. There were no complications in the other 11 pigs. The necropsy did not reveal any damage to organs adjacent to the stomach. Limitations Gastric wall incision is located on anterior gastric wall. Conclusions The PEG-like transgastric approach to the Peritoneal Cavity appears technically simple and safe.
Robert H Hawes - One of the best experts on this subject based on the ideXlab platform.
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preliminary pneumoperitoneum facilitates transgastric access into the Peritoneal Cavity for natural orifice transluminal endoscopic surgery a pilot study in a live porcine model
Endoscopy, 2007Co-Authors: Chungwang Ko, Christopher J Gostout, Sydney S C Chung, Peter B Cotton, Eun Ji Shin, Jonathan M Buscaglia, John O Clarke, Priscilla Magno, Samuel A Giday, Robert H HawesAbstract:BACKGROUND AND STUDY AIMS: Safe entrance into the Peritoneal Cavity through the gastric wall is paramount for the successful clinical introduction of natural orifice transluminal endoscopic surgery (NOTES). The aim of the study was to develop alternative safe transgastric access to the Peritoneal Cavity. PATIENTS AND METHODS: We performed 11 survival experiments on 50-kg pigs. In sterile conditions, the abdominal wall was punctured with a Veress needle. The Peritoneal Cavity was insufflated with 2 L carbon dioxide (CO 2 ). A sterile endoscope was introduced into the stomach through a sterile overtube; the gastric wall was punctured with a needle-knife; after balloon dilation of the puncture site, the endoscope was advanced into the Peritoneal Cavity. Peritoneoscopy with biopsies from abdominal wall, liver and omentum, was performed. The endoscope was withdrawn into the stomach. The animals were kept alive for 2 weeks and repeat endoscopy was followed by necropsy. RESULTS: The pneumoperitoneum, easily created with the Veress needle, lifted the abdominal wall and made a CO 2 -filled space between the stomach and adjacent organs, facilitating gastric wall puncture and advancement of the endoscope into the Peritoneal Cavity. There were no hemodynamic changes or immediate or delayed complications related to pneumoperitoneum, transgastric access, or intraPeritoneal manipulations. Follow-up endoscopy and necropsy revealed no problems or complications inside the stomach or Peritoneal Cavity. CONCLUSIONS: Creation of a preliminary pneumoperitoneum with a Veress needle facilitates gastric wall puncture and entrance into the Peritoneal Cavity without injury to adjacent organs, and can improve the safety of NOTES.
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a novel safe approach to the Peritoneal Cavity for per oral transgastric endoscopic procedures
Gastrointestinal Endoscopy, 2007Co-Authors: Sergey V Kantsevoy, Christopher J Gostout, Sanjay B Jagannath, Hideaki Niiyama, Nina V Isakovich, Sydney S C Chung, Peter B Cotton, Robert H Hawes, Pankaj J Pasricha, Anthony N KallooAbstract:Background We have previously reported the feasibility and safety of per-oral transgastric endoscopic procedures in a porcine model. Objective Our purpose was to evaluate the safety and feasibility of a PEG-like approach to the Peritoneal Cavity. Settings Acute experiments on 50-kg pigs under general anesthesia. Design and Interventions After per-oral intubation, the endoscope was positioned into the body of the stomach, the anterior abdominal wall was transilluminated and punctured with a needle, and a guidewire was inserted into the stomach through the needle. The guidewire was grasped with endoscopic forceps and pulled through the biopsy channel of the endoscope. A sphincterotome was inserted into the gastric wall over the guidewire. Gastric incision was performed and the endoscope was advanced into the Peritoneal Cavity. The Peritoneal Cavity was insufflated and endoscopic peritoneoscopy was performed. Then the animal was euthanized and necropsy was performed. Main Outcome Measures Safety of transgastric entrance to Peritoneal Cavity. Results The PEG-like approach was used in 12 pigs. The average procedure time was 11.4 ± 3.7 minutes. There was only 1 complication related to the access: bleeding from the gastric wall incision was documented when a pure cut (without coagulation) current was used for incision of the gastric wall. There were no complications in the other 11 pigs. The necropsy did not reveal any damage to organs adjacent to the stomach. Limitations Gastric wall incision is located on anterior gastric wall. Conclusions The PEG-like transgastric approach to the Peritoneal Cavity appears technically simple and safe.
Kazuki Sumiyama - One of the best experts on this subject based on the ideXlab platform.
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techniques for transgastric access to the Peritoneal Cavity
Gastrointestinal Endoscopy Clinics of North America, 2008Co-Authors: Kazuki Sumiyama, Christopher J GostoutAbstract:Natural orifice translumenal endoscopic surgery (NOTES) is a unique emerging surgical concept expanding flexible endoscopy beyond the gut wall. The methods and technology growing from this concept may minimize trauma from surgical access to the Peritoneal Cavity by completely eliminating body surface incisions. So far, NOTES surgeries have been reported by modifying laparoscopic surgery. The peroral transgastric route was chosen to access the Peritoneal Cavity in initial trials because of a potentially lower risk for surrounding organ injury using the anterior wall percutaneous endoscopic gastrostomy–style gastrotomy. This article reviews and describes techniques of transgastric access to the Peritoneal Cavity used in published animal studies.
Sydney S C Chung - One of the best experts on this subject based on the ideXlab platform.
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preliminary pneumoperitoneum facilitates transgastric access into the Peritoneal Cavity for natural orifice transluminal endoscopic surgery a pilot study in a live porcine model
Endoscopy, 2007Co-Authors: Chungwang Ko, Christopher J Gostout, Sydney S C Chung, Peter B Cotton, Eun Ji Shin, Jonathan M Buscaglia, John O Clarke, Priscilla Magno, Samuel A Giday, Robert H HawesAbstract:BACKGROUND AND STUDY AIMS: Safe entrance into the Peritoneal Cavity through the gastric wall is paramount for the successful clinical introduction of natural orifice transluminal endoscopic surgery (NOTES). The aim of the study was to develop alternative safe transgastric access to the Peritoneal Cavity. PATIENTS AND METHODS: We performed 11 survival experiments on 50-kg pigs. In sterile conditions, the abdominal wall was punctured with a Veress needle. The Peritoneal Cavity was insufflated with 2 L carbon dioxide (CO 2 ). A sterile endoscope was introduced into the stomach through a sterile overtube; the gastric wall was punctured with a needle-knife; after balloon dilation of the puncture site, the endoscope was advanced into the Peritoneal Cavity. Peritoneoscopy with biopsies from abdominal wall, liver and omentum, was performed. The endoscope was withdrawn into the stomach. The animals were kept alive for 2 weeks and repeat endoscopy was followed by necropsy. RESULTS: The pneumoperitoneum, easily created with the Veress needle, lifted the abdominal wall and made a CO 2 -filled space between the stomach and adjacent organs, facilitating gastric wall puncture and advancement of the endoscope into the Peritoneal Cavity. There were no hemodynamic changes or immediate or delayed complications related to pneumoperitoneum, transgastric access, or intraPeritoneal manipulations. Follow-up endoscopy and necropsy revealed no problems or complications inside the stomach or Peritoneal Cavity. CONCLUSIONS: Creation of a preliminary pneumoperitoneum with a Veress needle facilitates gastric wall puncture and entrance into the Peritoneal Cavity without injury to adjacent organs, and can improve the safety of NOTES.
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a novel safe approach to the Peritoneal Cavity for per oral transgastric endoscopic procedures
Gastrointestinal Endoscopy, 2007Co-Authors: Sergey V Kantsevoy, Christopher J Gostout, Sanjay B Jagannath, Hideaki Niiyama, Nina V Isakovich, Sydney S C Chung, Peter B Cotton, Robert H Hawes, Pankaj J Pasricha, Anthony N KallooAbstract:Background We have previously reported the feasibility and safety of per-oral transgastric endoscopic procedures in a porcine model. Objective Our purpose was to evaluate the safety and feasibility of a PEG-like approach to the Peritoneal Cavity. Settings Acute experiments on 50-kg pigs under general anesthesia. Design and Interventions After per-oral intubation, the endoscope was positioned into the body of the stomach, the anterior abdominal wall was transilluminated and punctured with a needle, and a guidewire was inserted into the stomach through the needle. The guidewire was grasped with endoscopic forceps and pulled through the biopsy channel of the endoscope. A sphincterotome was inserted into the gastric wall over the guidewire. Gastric incision was performed and the endoscope was advanced into the Peritoneal Cavity. The Peritoneal Cavity was insufflated and endoscopic peritoneoscopy was performed. Then the animal was euthanized and necropsy was performed. Main Outcome Measures Safety of transgastric entrance to Peritoneal Cavity. Results The PEG-like approach was used in 12 pigs. The average procedure time was 11.4 ± 3.7 minutes. There was only 1 complication related to the access: bleeding from the gastric wall incision was documented when a pure cut (without coagulation) current was used for incision of the gastric wall. There were no complications in the other 11 pigs. The necropsy did not reveal any damage to organs adjacent to the stomach. Limitations Gastric wall incision is located on anterior gastric wall. Conclusions The PEG-like transgastric approach to the Peritoneal Cavity appears technically simple and safe.
Peter B Cotton - One of the best experts on this subject based on the ideXlab platform.
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preliminary pneumoperitoneum facilitates transgastric access into the Peritoneal Cavity for natural orifice transluminal endoscopic surgery a pilot study in a live porcine model
Endoscopy, 2007Co-Authors: Chungwang Ko, Christopher J Gostout, Sydney S C Chung, Peter B Cotton, Eun Ji Shin, Jonathan M Buscaglia, John O Clarke, Priscilla Magno, Samuel A Giday, Robert H HawesAbstract:BACKGROUND AND STUDY AIMS: Safe entrance into the Peritoneal Cavity through the gastric wall is paramount for the successful clinical introduction of natural orifice transluminal endoscopic surgery (NOTES). The aim of the study was to develop alternative safe transgastric access to the Peritoneal Cavity. PATIENTS AND METHODS: We performed 11 survival experiments on 50-kg pigs. In sterile conditions, the abdominal wall was punctured with a Veress needle. The Peritoneal Cavity was insufflated with 2 L carbon dioxide (CO 2 ). A sterile endoscope was introduced into the stomach through a sterile overtube; the gastric wall was punctured with a needle-knife; after balloon dilation of the puncture site, the endoscope was advanced into the Peritoneal Cavity. Peritoneoscopy with biopsies from abdominal wall, liver and omentum, was performed. The endoscope was withdrawn into the stomach. The animals were kept alive for 2 weeks and repeat endoscopy was followed by necropsy. RESULTS: The pneumoperitoneum, easily created with the Veress needle, lifted the abdominal wall and made a CO 2 -filled space between the stomach and adjacent organs, facilitating gastric wall puncture and advancement of the endoscope into the Peritoneal Cavity. There were no hemodynamic changes or immediate or delayed complications related to pneumoperitoneum, transgastric access, or intraPeritoneal manipulations. Follow-up endoscopy and necropsy revealed no problems or complications inside the stomach or Peritoneal Cavity. CONCLUSIONS: Creation of a preliminary pneumoperitoneum with a Veress needle facilitates gastric wall puncture and entrance into the Peritoneal Cavity without injury to adjacent organs, and can improve the safety of NOTES.
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a novel safe approach to the Peritoneal Cavity for per oral transgastric endoscopic procedures
Gastrointestinal Endoscopy, 2007Co-Authors: Sergey V Kantsevoy, Christopher J Gostout, Sanjay B Jagannath, Hideaki Niiyama, Nina V Isakovich, Sydney S C Chung, Peter B Cotton, Robert H Hawes, Pankaj J Pasricha, Anthony N KallooAbstract:Background We have previously reported the feasibility and safety of per-oral transgastric endoscopic procedures in a porcine model. Objective Our purpose was to evaluate the safety and feasibility of a PEG-like approach to the Peritoneal Cavity. Settings Acute experiments on 50-kg pigs under general anesthesia. Design and Interventions After per-oral intubation, the endoscope was positioned into the body of the stomach, the anterior abdominal wall was transilluminated and punctured with a needle, and a guidewire was inserted into the stomach through the needle. The guidewire was grasped with endoscopic forceps and pulled through the biopsy channel of the endoscope. A sphincterotome was inserted into the gastric wall over the guidewire. Gastric incision was performed and the endoscope was advanced into the Peritoneal Cavity. The Peritoneal Cavity was insufflated and endoscopic peritoneoscopy was performed. Then the animal was euthanized and necropsy was performed. Main Outcome Measures Safety of transgastric entrance to Peritoneal Cavity. Results The PEG-like approach was used in 12 pigs. The average procedure time was 11.4 ± 3.7 minutes. There was only 1 complication related to the access: bleeding from the gastric wall incision was documented when a pure cut (without coagulation) current was used for incision of the gastric wall. There were no complications in the other 11 pigs. The necropsy did not reveal any damage to organs adjacent to the stomach. Limitations Gastric wall incision is located on anterior gastric wall. Conclusions The PEG-like transgastric approach to the Peritoneal Cavity appears technically simple and safe.
