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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

Mediastinoscopy. Retroflexed endoscopic views at (a) distal and (b) proximal thoracic spine.
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Related In: Results  -  Collection


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fig2: Mediastinoscopy. Retroflexed endoscopic views at (a) distal and (b) proximal thoracic spine.

Mentions: The posterior mediastinum was evaluated in all animals with no immediate complications. Changing the pig position from supine to prone allowed for spectacular visualization of the entire anterior thoracic spine, descending thoracic aorta, ribs, and the esophagus (Figures 2(a)-2(b)). Further changes in the pigs' position or manipulation of single-lung ventilation were not required to maintain adequate endoscopic visualization during spinal interventions.


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)

Mediastinoscopy. Retroflexed endoscopic views at (a) distal and (b) proximal thoracic spine.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig2: Mediastinoscopy. Retroflexed endoscopic views at (a) distal and (b) proximal thoracic spine.
Mentions: The posterior mediastinum was evaluated in all animals with no immediate complications. Changing the pig position from supine to prone allowed for spectacular visualization of the entire anterior thoracic spine, descending thoracic aorta, ribs, and the esophagus (Figures 2(a)-2(b)). Further changes in the pigs' position or manipulation of single-lung ventilation were not required to maintain adequate endoscopic visualization during spinal interventions.

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