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Natural orifice translumenal endoscopic surgery for anterior spinal procedures.

Magno P, Khashab MA, Mas M, Giday SA, Buscaglia JM, Shin EJ, Dray X, Kalloo AN - Minim Invasive Surg (2012)

Bottom Line: The posterior mediastinum was successfully accessed and navigated in all animals.Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, University of Puerto Rico School of Medicine, San Juan, PR 00936, USA.

ABSTRACT
Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae. Methods. Nonsurvival experiments on four 50-kg porcine animals were performed. Transesophageal access to the mediastinum was attained using submucosal tunneling technique. Results. The posterior mediastinum was successfully accessed and navigated in all animals. Vertebral bodies and intervertebral spaces were easily approached while avoiding damage to adjacent vessels. Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples. Conclusions. Peroral transesophageal access into the posterior mediastinum and thoracic vertebral bone biopsy was feasible and safe. The proximity of the esophagus to the vertebral column provides close and direct access to the thoracic spine and opens up new ground for the performance of multilevel anterior spine procedures using NOTES techniques.

No MeSH data available.


Related in: MedlinePlus

Transesophageal access. (a) Esophageal wall incision. (b) Submucosal tunnel. (c) Visualization of the lung, pleural, aorta, thoracic spine, and esophagus in forward scope position.
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fig1: Transesophageal access. (a) Esophageal wall incision. (b) Submucosal tunnel. (c) Visualization of the lung, pleural, aorta, thoracic spine, and esophagus in forward scope position.

Mentions: We performed acute experiments in four porcine models. Submucosal tunnel was successfully performed in all four pigs as described above and successful access to the mediastinum was attained without injury to any surrounding structures. After passing the endoscope through the completed myotomy, immediate and excellent visualization of lungs, pleura, and margins of the adventitial side of the esophagus were obtained (Figures 1(a)–1(c)). The mediastinal pleura was visualized on each side of the posterior mediastinum overlying the lungs and was not breached. The median time for completion of the transesophageal access was 12 minutes (range, 8–16 minutes).


Natural orifice translumenal endoscopic surgery for anterior spinal procedures.

Magno P, Khashab MA, Mas M, Giday SA, Buscaglia JM, Shin EJ, Dray X, Kalloo AN - Minim Invasive Surg (2012)

Transesophageal access. (a) Esophageal wall incision. (b) Submucosal tunnel. (c) Visualization of the lung, pleural, aorta, thoracic spine, and esophagus in forward scope position.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3368208&req=5

fig1: Transesophageal access. (a) Esophageal wall incision. (b) Submucosal tunnel. (c) Visualization of the lung, pleural, aorta, thoracic spine, and esophagus in forward scope position.
Mentions: We performed acute experiments in four porcine models. Submucosal tunnel was successfully performed in all four pigs as described above and successful access to the mediastinum was attained without injury to any surrounding structures. After passing the endoscope through the completed myotomy, immediate and excellent visualization of lungs, pleura, and margins of the adventitial side of the esophagus were obtained (Figures 1(a)–1(c)). The mediastinal pleura was visualized on each side of the posterior mediastinum overlying the lungs and was not breached. The median time for completion of the transesophageal access was 12 minutes (range, 8–16 minutes).

Bottom Line: The posterior mediastinum was successfully accessed and navigated in all animals.Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, University of Puerto Rico School of Medicine, San Juan, PR 00936, USA.

ABSTRACT
Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae. Methods. Nonsurvival experiments on four 50-kg porcine animals were performed. Transesophageal access to the mediastinum was attained using submucosal tunneling technique. Results. The posterior mediastinum was successfully accessed and navigated in all animals. Vertebral bodies and intervertebral spaces were easily approached while avoiding damage to adjacent vessels. Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples. Conclusions. Peroral transesophageal access into the posterior mediastinum and thoracic vertebral bone biopsy was feasible and safe. The proximity of the esophagus to the vertebral column provides close and direct access to the thoracic spine and opens up new ground for the performance of multilevel anterior spine procedures using NOTES techniques.

No MeSH data available.


Related in: MedlinePlus