Original articleExperimental endoscopyEUS in localizing safe alternate access sites for natural orifice transluminal endoscopic surgery: initial experience in a porcine model
Section snippets
Endoscopes and instruments
Endoscopes used in this study were a prototype forward-viewing echoendoscope (GIF-UCT160J-AL5), a standard curved linear array (CLA) echoendoscope (GIF-UCT160EUS; Olympus), and a standard single-channel gastroscope (GIF-130; Olympus). Instruments used during the access procedures were a triple-lumen needle-knife catheter (Microvasive Endoscopy, Boston Scientific Corp, Natick, Mass), a 19-gauge EUS-FNA needle (Olympus), a 0.89-mm × 400-cm Jagwire (Microvasive), and an 18-mm to 20-mm controlled
Results
All 32 access procedures resulted in successful peritoneal entry. Of the 16 SAPs, 13 were without complication. In contrast, all 16 UAPs resulted in complications.
Discussion
By using EUS to target at-risk extraluminal organs and vessels, we were able to demonstrate the potential complications of blind NOTES access through sites other than the anterior gastric wall. When EUS was used to identify and avoid such structures, however, access through these sites was substantially safer and less likely to result in a major complication. These findings, although preliminary, suggest that EUS is useful in identifying safe alternate access sites for NOTES.
In this study, the
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