Feasibility Study of EUS-NOTES as a Novel Approach for Pancreatic Cancer Staging and Therapy: An International Collaborative Study

TY - JOUR

T1 - Feasibility Study of EUS-NOTES as a Novel Approach for Pancreatic Cancer Staging and Therapy

T2 - An International Collaborative Study

AU - Săftoiu, Adrian

AU - Bhutani, Manoop S

AU - Vilmann, Peter

AU - Surlin, Valeriu

AU - Uthamanthil, Rajesh K

AU - Lee, Jeffrey H

AU - Bektas, Mehmet

AU - Singh, Harvinder

AU - Gheonea, Dan Ionuţ

AU - Pătraşcu, Stefan

AU - Gupta, Vikas

AU - Katz, Matthew H

AU - Fleming, Jason B

PY - 2013/3

Y1 - 2013/3

N2 - Background/Aims: EUS guided Natural Orifice Transluminal Endoscopic Surgery (NOTES) could be a potentially viable approach for pancreatic surgery. EUS-guided access through the stomach wall may prove to be a safe and effective method for accessing the pancreas. The aim of the study was to assess the EUS-guided diagnostic and therapeutic procedures during NOTES for both anterior and posterior approach of the pancreas. Methodology: The feasibility of peritoneoscopy through an anterior EUS-guided transgastric approach, as well as direct access to the pancreas through a posterior EUS-guided transgastric approach was tested for ease of access to the tail of the pancreas. Gastric wound closure was finally performed in several animals using various commercial and prototype endoscopic accessories. Results: The results showed the ability of EUS-NOTES technology to facilitate a transgastric approach and provide both an anterior and posterior access the pancreas. Identification the pancreatic tail by EUS with the aid of EUS-guided T-tag insertion, as well as posterior access and subsequent inspection/dissection of the pancreatic tail may also be possible. Conclusions: It is technically possible by EUS-guided NOTES procedures to achieve a systematic anterior and posterior access for NOTES transgastric peritoneoscopy and direct pancreatic endoscopic procedures.

AB - Background/Aims: EUS guided Natural Orifice Transluminal Endoscopic Surgery (NOTES) could be a potentially viable approach for pancreatic surgery. EUS-guided access through the stomach wall may prove to be a safe and effective method for accessing the pancreas. The aim of the study was to assess the EUS-guided diagnostic and therapeutic procedures during NOTES for both anterior and posterior approach of the pancreas. Methodology: The feasibility of peritoneoscopy through an anterior EUS-guided transgastric approach, as well as direct access to the pancreas through a posterior EUS-guided transgastric approach was tested for ease of access to the tail of the pancreas. Gastric wound closure was finally performed in several animals using various commercial and prototype endoscopic accessories. Results: The results showed the ability of EUS-NOTES technology to facilitate a transgastric approach and provide both an anterior and posterior access the pancreas. Identification the pancreatic tail by EUS with the aid of EUS-guided T-tag insertion, as well as posterior access and subsequent inspection/dissection of the pancreatic tail may also be possible. Conclusions: It is technically possible by EUS-guided NOTES procedures to achieve a systematic anterior and posterior access for NOTES transgastric peritoneoscopy and direct pancreatic endoscopic procedures.

U2 - 10.5754/hge11774

DO - 10.5754/hge11774

M3 - Journal article

C2 - 22776721

SN - 0172-6390

VL - 60

JO - Hepato-Gastroenterology

JF - Hepato-Gastroenterology

IS - 121

ER -