NOTES-case report of a unidirectional flexible appendectomy
NOTES-case report of a unidirectional flexible appendectomy
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DOI：
10.1007/s00384-007-0427-3
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发表时间：
2008-05-01
影响因子：
2.8
通讯作者：
Ludwig, Kaja
中科院分区：
文献类型：
--
作者：
Bernhardt, Joern;Gerber, Bernd;Ludwig, Kaja
自然腔道经腔内窥镜手术（NOTES）是指在腹腔内使用软式内窥镜的一种新的外科手术。通过这种手术，可以通过一个自然的、已经存在的外部孔进入器官。与这种方法相关的希望的优点包括减少术后伤口疼痛，缩短康复期，避免伤口感染和腹壁疝以及没有疤痕。我们进行了经阴道阑尾切除术对人类subject.Materials和方法在动物的实验操作，我们首先评估了经阴道的访问网站。在他们之后，我们开始了人类的第一次手术。在预防性给予抗生素的情况下进行该手术。我们使用了治疗性单管胃镜。阑尾是在腹部探查后找到的。准备肠系膜后，通过圈套器结扎阑尾基部，然后用剪刀横切。恢复的标本是通过拔出它与instrument.Results当天晚上手术已经发生，管理的营养开始。手术后，患者报告腹壁肌肉有轻微疼痛;除此之外，她感觉很好。解释在一年的时间里，第一批手术已经由几个选定的工作组在人类身上进行。NOTES程序仍处于临床开发的初始阶段。在它们能够被引入到外科日常工作中之前，需要进一步改进设备、技术和手术程序。
Background Natural orifice transluminal endoscopic surgery (NOTES) refers to a new surgical procedure using flexible endoscopes in the abdominal cavity. With this procedure, access is gained by way of organs which are reached through a natural, already-existing external orifice. The hoped-for advantages associated with this method include the reduction of post-operative wound pain, shorter convalescence, avoidance of wound infection and abdominal-wall hernias as well as the absence of scars. We performed a trans-vaginal appendectomy on a human subject.Materials and methods In experimental operations on animals, we first evaluated the trans-vaginal access site. After them, we started first operation in human. The procedure was carried out under preventive administration of antibiotics. We used a therapeutic single-canal gastroscope. The appendix was located after exploration of the abdomen. After preparation of the mesenteriolum, ligature of the appendix base was performed by means of endoloop, followed by transsection with scissors. Recovery of the specimen was achieved by pulling it out with the instrument.Results On the evening of the day on which surgery had taken place, administration of nourishment was begun. After the procedure, the patient reported slight soreness in the muscles of the abdominal wall; she felt otherwise perfectly well.Interpretation In the space of a year, the first operations have been performed on human subjects by a few select work groups. NOTES procedures are still in the initial stages of clinical development. Until they can be introduced into surgical daily routine, further improvements are required as to equipment, technology and operative procedure.