Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)
Background An isolated transgastric port has some limitations in performing transluminal endoscopic cholecystectomy. However, transvesical access to the peritoneal cavity has recently been reported to be feasible and safe. Objective To assess the feasibility and the technical benefits of transgastri...
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| creator | Rolanda, Carla, MD Lima, Estêvão, MD Pêgo, José M., MD Henriques-Coelho, Tiago, MD Silva, David, MD Moreira, Ivone Macedo, Guilherme, MD, PhD Carvalho, José L., MD Correia-Pinto, Jorge, MD, PhD |
| description | Background An isolated transgastric port has some limitations in performing transluminal endoscopic cholecystectomy. However, transvesical access to the peritoneal cavity has recently been reported to be feasible and safe. Objective To assess the feasibility and the technical benefits of transgastric and transvesical combined approach to overcome the limitations of isolated transgastric ports. Design We created a transgastric and transvesical combined approach to perform cholecystectomy in 7 consecutive anesthetized female pigs. The transgastric access was achieved after perforation and dilation of the gastric wall with a needle knife and with a balloon, respectively. Under cystoscopic control, an ureteral catheter, a guidewire, and a dilator of the ureteral sheath were used to place a transvesical 5-mm overtube into the peritoneal cavity. By using a gastroscope positioned transgastrically and a ureteroscope positioned transvesically, we carried out cholecystectomy in all animals. Results Establishment of transvesical and transgastric accesses took place without complications. Under a carbon dioxide pneumoperitoneum controlled by the transvesical port, gallbladder identification, cystic duct, and artery exposure were easily achieved in all cases. Transvesical gallbladder grasping and manipulation proved to be particularly valuable to enhance gastroscope-guided dissection. With the exclusion of 2 cases where mild liver-surface hemorrhage and bile leak secondary to the sliding of cystic clips occurred, all remaining cholecystectomies were carried out without incidents. Limitations Once closure of the gastric hole proved to be unreliable when using endoclips, the animals were euthanized; necropsy was performed immediately after the surgical procedure. Conclusions A transgastric and transvesical combined approach is feasible, and it was particularly useful to perform a cholecystectomy through exclusive natural orifices. |
| doi_str_mv | 10.1016/j.gie.2006.07.050 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68388454</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0016510706025788</els_id><sourcerecordid>68388454</sourcerecordid><originalsourceid>FETCH-LOGICAL-c570t-22276f648ab987b002dce95d28192a503a48107f7b8b6a65fc178c67587979843</originalsourceid><addsrcrecordid>eNp9kl2r1DAQhoMonvXoD_BGeqPoResk3XxUQZCDX3DAC4_XIU2nu1nbZE3alf57U3bhgBdeBYbnHSbPDCHPKVQUqHh7qHYOKwYgKpAVcHhANhQaWQopm4dkAxkqOQV5RZ6kdAAAxWr6mFxRSRUH1WxIvNu72JU79BjN5IIv7D4MaJc0oZ3CuBTtUngzzdEMRYiudxbTu2KKxqedSVN0tjC-OxdOmJzNnA1j6zx2hTkeYzB2X7z-46Z9cXIdhjdPyaPeDAmfXd5r8vPzp7ubr-Xt9y_fbj7elpZLmErGmBS92CrTNkq2AKyz2PCOKdoww6E2W5W_1stWtcII3lsqlRWSK9nIRm3ra_Lq3DfP8HvGNOnRJYvDYDyGOWmhaqW2fAXpGbQxpBSx18foRhMXTUGvovVBZ9F6Fa1B6iw6Z15cms_tiN194mI2Ay8vgEnZSZ_9WJfuOaUYo1Jk7v2Zw6zi5DDqZB16i52LeQO6C-6_Y3z4J20H59cl_MIF0yHM0WfHmurENOgf60WsBwECGJdK1X8BVayw1Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68388454</pqid></control><display><type>article</type><title>Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Rolanda, Carla, MD ; Lima, Estêvão, MD ; Pêgo, José M., MD ; Henriques-Coelho, Tiago, MD ; Silva, David, MD ; Moreira, Ivone ; Macedo, Guilherme, MD, PhD ; Carvalho, José L., MD ; Correia-Pinto, Jorge, MD, PhD</creator><creatorcontrib>Rolanda, Carla, MD ; Lima, Estêvão, MD ; Pêgo, José M., MD ; Henriques-Coelho, Tiago, MD ; Silva, David, MD ; Moreira, Ivone ; Macedo, Guilherme, MD, PhD ; Carvalho, José L., MD ; Correia-Pinto, Jorge, MD, PhD</creatorcontrib><description>Background An isolated transgastric port has some limitations in performing transluminal endoscopic cholecystectomy. However, transvesical access to the peritoneal cavity has recently been reported to be feasible and safe. Objective To assess the feasibility and the technical benefits of transgastric and transvesical combined approach to overcome the limitations of isolated transgastric ports. Design We created a transgastric and transvesical combined approach to perform cholecystectomy in 7 consecutive anesthetized female pigs. The transgastric access was achieved after perforation and dilation of the gastric wall with a needle knife and with a balloon, respectively. Under cystoscopic control, an ureteral catheter, a guidewire, and a dilator of the ureteral sheath were used to place a transvesical 5-mm overtube into the peritoneal cavity. By using a gastroscope positioned transgastrically and a ureteroscope positioned transvesically, we carried out cholecystectomy in all animals. Results Establishment of transvesical and transgastric accesses took place without complications. Under a carbon dioxide pneumoperitoneum controlled by the transvesical port, gallbladder identification, cystic duct, and artery exposure were easily achieved in all cases. Transvesical gallbladder grasping and manipulation proved to be particularly valuable to enhance gastroscope-guided dissection. With the exclusion of 2 cases where mild liver-surface hemorrhage and bile leak secondary to the sliding of cystic clips occurred, all remaining cholecystectomies were carried out without incidents. Limitations Once closure of the gastric hole proved to be unreliable when using endoclips, the animals were euthanized; necropsy was performed immediately after the surgical procedure. Conclusions A transgastric and transvesical combined approach is feasible, and it was particularly useful to perform a cholecystectomy through exclusive natural orifices.</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/j.gie.2006.07.050</identifier><identifier>PMID: 17185089</identifier><identifier>CODEN: GAENBQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Abdomen ; Animals ; Biological and medical sciences ; Cholecystectomy - methods ; Digestive system. Abdomen ; Endoscopy ; Feasibility Studies ; Female ; Gastroenterology and Hepatology ; Gastroenterology. Liver. Pancreas. Abdomen ; Investigative techniques, diagnostic techniques (general aspects) ; Liver, biliary tract, pancreas, portal circulation, spleen ; Medical sciences ; Other diseases. Semiology ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Swine</subject><ispartof>Gastrointestinal endoscopy, 2007, Vol.65 (1), p.111-117</ispartof><rights>American Society for Gastrointestinal Endoscopy</rights><rights>2007 American Society for Gastrointestinal Endoscopy</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c570t-22276f648ab987b002dce95d28192a503a48107f7b8b6a65fc178c67587979843</citedby><cites>FETCH-LOGICAL-c570t-22276f648ab987b002dce95d28192a503a48107f7b8b6a65fc178c67587979843</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0016510706025788$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18822176$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17185089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rolanda, Carla, MD</creatorcontrib><creatorcontrib>Lima, Estêvão, MD</creatorcontrib><creatorcontrib>Pêgo, José M., MD</creatorcontrib><creatorcontrib>Henriques-Coelho, Tiago, MD</creatorcontrib><creatorcontrib>Silva, David, MD</creatorcontrib><creatorcontrib>Moreira, Ivone</creatorcontrib><creatorcontrib>Macedo, Guilherme, MD, PhD</creatorcontrib><creatorcontrib>Carvalho, José L., MD</creatorcontrib><creatorcontrib>Correia-Pinto, Jorge, MD, PhD</creatorcontrib><title>Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>Background An isolated transgastric port has some limitations in performing transluminal endoscopic cholecystectomy. However, transvesical access to the peritoneal cavity has recently been reported to be feasible and safe. Objective To assess the feasibility and the technical benefits of transgastric and transvesical combined approach to overcome the limitations of isolated transgastric ports. Design We created a transgastric and transvesical combined approach to perform cholecystectomy in 7 consecutive anesthetized female pigs. The transgastric access was achieved after perforation and dilation of the gastric wall with a needle knife and with a balloon, respectively. Under cystoscopic control, an ureteral catheter, a guidewire, and a dilator of the ureteral sheath were used to place a transvesical 5-mm overtube into the peritoneal cavity. By using a gastroscope positioned transgastrically and a ureteroscope positioned transvesically, we carried out cholecystectomy in all animals. Results Establishment of transvesical and transgastric accesses took place without complications. Under a carbon dioxide pneumoperitoneum controlled by the transvesical port, gallbladder identification, cystic duct, and artery exposure were easily achieved in all cases. Transvesical gallbladder grasping and manipulation proved to be particularly valuable to enhance gastroscope-guided dissection. With the exclusion of 2 cases where mild liver-surface hemorrhage and bile leak secondary to the sliding of cystic clips occurred, all remaining cholecystectomies were carried out without incidents. Limitations Once closure of the gastric hole proved to be unreliable when using endoclips, the animals were euthanized; necropsy was performed immediately after the surgical procedure. Conclusions A transgastric and transvesical combined approach is feasible, and it was particularly useful to perform a cholecystectomy through exclusive natural orifices.</description><subject>Abdomen</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Cholecystectomy - methods</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Swine</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2r1DAQhoMonvXoD_BGeqPoResk3XxUQZCDX3DAC4_XIU2nu1nbZE3alf57U3bhgBdeBYbnHSbPDCHPKVQUqHh7qHYOKwYgKpAVcHhANhQaWQopm4dkAxkqOQV5RZ6kdAAAxWr6mFxRSRUH1WxIvNu72JU79BjN5IIv7D4MaJc0oZ3CuBTtUngzzdEMRYiudxbTu2KKxqedSVN0tjC-OxdOmJzNnA1j6zx2hTkeYzB2X7z-46Z9cXIdhjdPyaPeDAmfXd5r8vPzp7ubr-Xt9y_fbj7elpZLmErGmBS92CrTNkq2AKyz2PCOKdoww6E2W5W_1stWtcII3lsqlRWSK9nIRm3ra_Lq3DfP8HvGNOnRJYvDYDyGOWmhaqW2fAXpGbQxpBSx18foRhMXTUGvovVBZ9F6Fa1B6iw6Z15cms_tiN194mI2Ay8vgEnZSZ_9WJfuOaUYo1Jk7v2Zw6zi5DDqZB16i52LeQO6C-6_Y3z4J20H59cl_MIF0yHM0WfHmurENOgf60WsBwECGJdK1X8BVayw1Q</recordid><startdate>2007</startdate><enddate>2007</enddate><creator>Rolanda, Carla, MD</creator><creator>Lima, Estêvão, MD</creator><creator>Pêgo, José M., MD</creator><creator>Henriques-Coelho, Tiago, MD</creator><creator>Silva, David, MD</creator><creator>Moreira, Ivone</creator><creator>Macedo, Guilherme, MD, PhD</creator><creator>Carvalho, José L., MD</creator><creator>Correia-Pinto, Jorge, MD, PhD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2007</creationdate><title>Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)</title><author>Rolanda, Carla, MD ; Lima, Estêvão, MD ; Pêgo, José M., MD ; Henriques-Coelho, Tiago, MD ; Silva, David, MD ; Moreira, Ivone ; Macedo, Guilherme, MD, PhD ; Carvalho, José L., MD ; Correia-Pinto, Jorge, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c570t-22276f648ab987b002dce95d28192a503a48107f7b8b6a65fc178c67587979843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Abdomen</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Cholecystectomy - methods</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Swine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rolanda, Carla, MD</creatorcontrib><creatorcontrib>Lima, Estêvão, MD</creatorcontrib><creatorcontrib>Pêgo, José M., MD</creatorcontrib><creatorcontrib>Henriques-Coelho, Tiago, MD</creatorcontrib><creatorcontrib>Silva, David, MD</creatorcontrib><creatorcontrib>Moreira, Ivone</creatorcontrib><creatorcontrib>Macedo, Guilherme, MD, PhD</creatorcontrib><creatorcontrib>Carvalho, José L., MD</creatorcontrib><creatorcontrib>Correia-Pinto, Jorge, MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rolanda, Carla, MD</au><au>Lima, Estêvão, MD</au><au>Pêgo, José M., MD</au><au>Henriques-Coelho, Tiago, MD</au><au>Silva, David, MD</au><au>Moreira, Ivone</au><au>Macedo, Guilherme, MD, PhD</au><au>Carvalho, José L., MD</au><au>Correia-Pinto, Jorge, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2007</date><risdate>2007</risdate><volume>65</volume><issue>1</issue><spage>111</spage><epage>117</epage><pages>111-117</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><coden>GAENBQ</coden><abstract>Background An isolated transgastric port has some limitations in performing transluminal endoscopic cholecystectomy. However, transvesical access to the peritoneal cavity has recently been reported to be feasible and safe. Objective To assess the feasibility and the technical benefits of transgastric and transvesical combined approach to overcome the limitations of isolated transgastric ports. Design We created a transgastric and transvesical combined approach to perform cholecystectomy in 7 consecutive anesthetized female pigs. The transgastric access was achieved after perforation and dilation of the gastric wall with a needle knife and with a balloon, respectively. Under cystoscopic control, an ureteral catheter, a guidewire, and a dilator of the ureteral sheath were used to place a transvesical 5-mm overtube into the peritoneal cavity. By using a gastroscope positioned transgastrically and a ureteroscope positioned transvesically, we carried out cholecystectomy in all animals. Results Establishment of transvesical and transgastric accesses took place without complications. Under a carbon dioxide pneumoperitoneum controlled by the transvesical port, gallbladder identification, cystic duct, and artery exposure were easily achieved in all cases. Transvesical gallbladder grasping and manipulation proved to be particularly valuable to enhance gastroscope-guided dissection. With the exclusion of 2 cases where mild liver-surface hemorrhage and bile leak secondary to the sliding of cystic clips occurred, all remaining cholecystectomies were carried out without incidents. Limitations Once closure of the gastric hole proved to be unreliable when using endoclips, the animals were euthanized; necropsy was performed immediately after the surgical procedure. Conclusions A transgastric and transvesical combined approach is feasible, and it was particularly useful to perform a cholecystectomy through exclusive natural orifices.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>17185089</pmid><doi>10.1016/j.gie.2006.07.050</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Animals Biological and medical sciences Cholecystectomy - methods Digestive system. Abdomen Endoscopy Feasibility Studies Female Gastroenterology and Hepatology Gastroenterology. Liver. Pancreas. Abdomen Investigative techniques, diagnostic techniques (general aspects) Liver, biliary tract, pancreas, portal circulation, spleen Medical sciences Other diseases. Semiology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Swine |
| title | Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video) |
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