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KMID : 1094020110280054970
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Journal of Veterinary Clinics
2011 Volume.28 No. 5 p.4970 ~ p.505
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Hybrid Natural Orifice Transluminal Endoscopic Cholecystectomy in Dogs - Transgastric, Transcolonic and Transvaginal Approaches
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Kim Soo-Hyun
Jeong Seong-Mok
Shin Sa-Kyeng
Kim Seong-Su
Shin Beom-Jun
Lee Jae-Yeon
Park Ji-yeong
Kim Myung-Cheol
Kim Young-Ill
Lee Sang-Il
Kim Ji-Yeon
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Abstract
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Natural orifice transluminal endoscopic surgery is a newly emerging technique recently, with its many potential advantages in clinical practice. Cholecystectomy by Hybrid NOTES in this work, performed with single working channel endoscope in conjunction with a laparoscopic grasping forceps in dogs, is a “bridge” between laparoscopic procedure and pure NOTES. Three different approaches for cholecystectomy were carried out; transgastric, transcolonic and transvaginal. In all three approaches, abdominal opening was made by a 5 mm trocar, followed by making pneumoperitoneum of 4 mmHg with CO₂ insufflator. Transgastric cholecystectomy, single working channel endoscope was advanced to the peritoneal cavity through gastric incision in antral region made by endoscopic needle knife. Endoscope was retroflexed to visualize the gall bladder. Transcolonic access, incision for endoscopic entry was done at right ventral wall of descending colon, 15 cm inside from the anus. Incision in transvaginal access was made at right-ventral region, just caudal to the caudal tubercle. With the simple traction by the laparoscopic grasping forceps, good visualization of surgical field was obtained in all three groups. Cystic duct and artery were ligated with endoclips; for complete gall bladder dissection from liver, L-knife was used. Closure of incision sites were done in transgastric and transcolonic cholecystectomy by endoclips, not in transvaginal approach.
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KEYWORD
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Hybrid NOTES, transgastric, transcolonic, transvaginal, dog
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