Overview
Transection of the stomach, often explored in the context of natural orifice transluminal endoscopic surgery (NOTES), involves accessing and manipulating the abdominal cavity through the stomach wall for various procedures such as transgastric tube resection, cholecystectomy, cardiomyotomy, and small bowel segmental resection. 1Diagnosis
Imaging: Preoperative imaging (e.g., CT, MRI) to assess anatomy and feasibility.
Endoscopic Evaluation: Initial endoscopic assessment to evaluate gastric entry points and potential complications.
Training Models: Porcine models used for procedural training and technique validation. 1Management
Training Programs: Development and implementation of structured training programs for gastroenterologists and surgeons using animal models.
Procedural Techniques: Specific techniques including transgastric tube resection (TTR), cholecystectomy (TCE), cardiomyotomy (TMY), and small bowel segmental resection (TSBR).
Instrumentation: Utilization of currently available endoscopic instruments adapted for transgastric procedures. 1Special Populations
Training Focus: Abstracts primarily focus on training methodologies without specific details on pregnancy, pediatrics, elderly, or comorbidities. 1Key Recommendations
Establish structured training programs using animal models for transgastric procedures to enhance procedural skills for both gastroenterologists and surgeons. (Evidence: Expert opinion) 1
Implement a stepwise training approach including basic steps before advancing to more complex procedures like cholecystectomy and bowel resections. (Evidence: Expert opinion) 1
Utilize porcine models with median weights around 65 kg for training sessions to simulate human anatomy effectively. (Evidence: Expert opinion) 1References
1 Fuchs KH, Breithaupt W, Kühl HJ, Schulz T, Dignass A. Experience with a training program for transgastric procedures in NOTES. Surgical endoscopy 2010. link