Natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation in a porcine model

Sebastien Crouzet, Georges Pascal Haber, Kazumi Kamoi, Andre Berger, Stacy Brethauer, Patrick Gatmaitan, Inderbir S. Gill, Jihad H. Kaouk

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

OBJECTIVE: To present our laboratory experience with natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation. MATERIALS AND METHODS: In two female farm pigs, we performed four procedures of NOTES renal cryoablation. In each pig, NOTES was performed through a transgastric approach and a transvaginal approach for each kidney, respectively. The pig was placed in the flank position and pneumoperitoneum obtained using a transabdominal Veress needle. In the first pig, we started with the left kidney with a transgastric approach: a dual-channel video gastroscope (Olympus, Tokyo, Japan) was used, the stomach wall was punctured using a needle-knife, a guidewire was passed into the abdominal cavity and the access dilated using a controlled radial expansion balloon. The bowel was mobilized medially and the Gerota's fascia overlying the upper pole was dissected. Under direct endoscopic vision, a cryoablation probe was introduced percutaneously into the anterior upper pole of the kidney. The pig was then flipped to the right flank position and a transvaginal approach was used: the gastroscope was introduced through the posterior fornix of the vagina. For the second pig, we performed initially a transgastric right-side cryoablation then a transvaginal left-side cryoablation as described for the first pig. RESULTS: All four procedures were performed successfully, with no intraoperative complications. No additional laparoscopic ports or open conversions were necessary. The vision of the kidney and the ice-ball was adequate for all cases. The mean operative duration was 83 min. Stomach closure was tested watertight, and there were no abdominal or pelvic injuries found at autopsy. CONCLUSIONS: NOTES can provide adequate minimal surgical dissection for safe and effective percutaneous renal cryoablation under direct videoscopic monitoring at kidney locations otherwise not accessible percutaneously. Both transgastric and transvaginal approaches can be used effectively for renal cryoablation providing a minimally invasive scar-less surgery.

Original languageEnglish (US)
Pages (from-to)1715-1718
Number of pages4
JournalBJU International
Volume102
Issue number11
DOIs
StatePublished - Dec 2008
Externally publishedYes

Fingerprint

Natural Orifice Endoscopic Surgery
Cryosurgery
Swine
Kidney
Gastroscopes
Needles
Stomach
Pneumoperitoneum
Tokyo
Abdominal Cavity
Fascia
Intraoperative Complications
Ice
Vagina
Cicatrix
Dissection
Autopsy
Japan

Keywords

  • Cryoablation
  • Kidney
  • NOTES
  • Percutaneous
  • Tumour

ASJC Scopus subject areas

  • Urology

Cite this

Crouzet, S., Haber, G. P., Kamoi, K., Berger, A., Brethauer, S., Gatmaitan, P., ... Kaouk, J. H. (2008). Natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation in a porcine model. BJU International, 102(11), 1715-1718. https://doi.org/10.1111/j.1464-410X.2008.07880.x

Natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation in a porcine model. / Crouzet, Sebastien; Haber, Georges Pascal; Kamoi, Kazumi; Berger, Andre; Brethauer, Stacy; Gatmaitan, Patrick; Gill, Inderbir S.; Kaouk, Jihad H.

In: BJU International, Vol. 102, No. 11, 12.2008, p. 1715-1718.

Research output: Contribution to journalArticle

Crouzet, S, Haber, GP, Kamoi, K, Berger, A, Brethauer, S, Gatmaitan, P, Gill, IS & Kaouk, JH 2008, 'Natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation in a porcine model', BJU International, vol. 102, no. 11, pp. 1715-1718. https://doi.org/10.1111/j.1464-410X.2008.07880.x
Crouzet, Sebastien ; Haber, Georges Pascal ; Kamoi, Kazumi ; Berger, Andre ; Brethauer, Stacy ; Gatmaitan, Patrick ; Gill, Inderbir S. ; Kaouk, Jihad H. / Natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation in a porcine model. In: BJU International. 2008 ; Vol. 102, No. 11. pp. 1715-1718.
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N2 - OBJECTIVE: To present our laboratory experience with natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation. MATERIALS AND METHODS: In two female farm pigs, we performed four procedures of NOTES renal cryoablation. In each pig, NOTES was performed through a transgastric approach and a transvaginal approach for each kidney, respectively. The pig was placed in the flank position and pneumoperitoneum obtained using a transabdominal Veress needle. In the first pig, we started with the left kidney with a transgastric approach: a dual-channel video gastroscope (Olympus, Tokyo, Japan) was used, the stomach wall was punctured using a needle-knife, a guidewire was passed into the abdominal cavity and the access dilated using a controlled radial expansion balloon. The bowel was mobilized medially and the Gerota's fascia overlying the upper pole was dissected. Under direct endoscopic vision, a cryoablation probe was introduced percutaneously into the anterior upper pole of the kidney. The pig was then flipped to the right flank position and a transvaginal approach was used: the gastroscope was introduced through the posterior fornix of the vagina. For the second pig, we performed initially a transgastric right-side cryoablation then a transvaginal left-side cryoablation as described for the first pig. RESULTS: All four procedures were performed successfully, with no intraoperative complications. No additional laparoscopic ports or open conversions were necessary. The vision of the kidney and the ice-ball was adequate for all cases. The mean operative duration was 83 min. Stomach closure was tested watertight, and there were no abdominal or pelvic injuries found at autopsy. CONCLUSIONS: NOTES can provide adequate minimal surgical dissection for safe and effective percutaneous renal cryoablation under direct videoscopic monitoring at kidney locations otherwise not accessible percutaneously. Both transgastric and transvaginal approaches can be used effectively for renal cryoablation providing a minimally invasive scar-less surgery.

AB - OBJECTIVE: To present our laboratory experience with natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation. MATERIALS AND METHODS: In two female farm pigs, we performed four procedures of NOTES renal cryoablation. In each pig, NOTES was performed through a transgastric approach and a transvaginal approach for each kidney, respectively. The pig was placed in the flank position and pneumoperitoneum obtained using a transabdominal Veress needle. In the first pig, we started with the left kidney with a transgastric approach: a dual-channel video gastroscope (Olympus, Tokyo, Japan) was used, the stomach wall was punctured using a needle-knife, a guidewire was passed into the abdominal cavity and the access dilated using a controlled radial expansion balloon. The bowel was mobilized medially and the Gerota's fascia overlying the upper pole was dissected. Under direct endoscopic vision, a cryoablation probe was introduced percutaneously into the anterior upper pole of the kidney. The pig was then flipped to the right flank position and a transvaginal approach was used: the gastroscope was introduced through the posterior fornix of the vagina. For the second pig, we performed initially a transgastric right-side cryoablation then a transvaginal left-side cryoablation as described for the first pig. RESULTS: All four procedures were performed successfully, with no intraoperative complications. No additional laparoscopic ports or open conversions were necessary. The vision of the kidney and the ice-ball was adequate for all cases. The mean operative duration was 83 min. Stomach closure was tested watertight, and there were no abdominal or pelvic injuries found at autopsy. CONCLUSIONS: NOTES can provide adequate minimal surgical dissection for safe and effective percutaneous renal cryoablation under direct videoscopic monitoring at kidney locations otherwise not accessible percutaneously. Both transgastric and transvaginal approaches can be used effectively for renal cryoablation providing a minimally invasive scar-less surgery.

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