有效安全的无菌术是手术的最基本要求。经自然腔道内镜手术（NOTES）具有创伤小疼痛少、胰腺胃后壁疾病建立手术通路方便快捷等优点。作为NOTES代表的经口内镜下肌切开术（POEM）近期也广泛开展,在良好治疗效果的同时也暴露了感染的风险。NOTES无菌术与内镜手术、外科手术都有极大不同，NOTES无菌术的机制及方法体系国内外尚未系统研究，如何认识和实施NOTES无菌术成为当前和未来急需解决的问题。作为国内最早开展NOTES研究的单位之一，伦理委员会批准后，在动物实验和临床应用基础上对NOTES无菌术进行了初步研究并发表了SCI论文。本课题拟对最常用的NOTES手术途径-经食管胃途径无菌术各环节相关因素进行系统研究，包括手术设备器械灭菌法、细菌种类负荷、有效安全的消毒剂筛选应用、管壁切口闭合方式，NOTES手术方法流程中的无菌术机制等，打牢基础，以期构建安全有效的NOTES无菌术方法体系。

Effective and safe aseptic is the most basic requirement of surgery. As a new surgical approach, natural orifice transluminal endoscopic surgery (NOTES) is gradually accepted due to the advantage of minimally invasive, painless and unique advantages of access to pancreas and posterior wall of stomach. But NOTES aseptic technique is quite different with endoscopic surgery and typical surgery. The mechanism and implementation process of NOTES aseptic technique is not yet systematic studied around the world. Transgastric NOTES is one of the most commonly used approach beacause of its small bacterial load, simple pathways established, and easily be accepted by patients. As one of the first units carrying out NOTES research,we have conducted a preliminary study of NOTES aseptic technique and published SCI papers.In this study we intend to carry out systematic research on relevant factors of NOTES aseptic，including sterilization methods of surgical endoscope,bacterial culture and identification of gastric juice,concentration and duration of disinfectant in vitro sterilization,the mucousal and systemic effects of disinfectants on the animal, effectiveness of the gastric wall incision closure,simulation disinfection in gastric polypectomy patients,NOTES devices application process,bacterial culture and identification of surgical procedures.In order to identify the mechanism of aseptic in transgastric NOTES and establish a safe and effective aseptic methodology of transgastric NOTES.