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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1427_Библиотеки_им_академика_М_И_Перельмана.pdf
NOTES, steps of, 65, 67f, 68f, 69f
techniques of, 62f
via submucosal tunnel, 62–63
G
Gastric electrical stimulation (GES), 97, 98, 115
Gastric emptying, 112, 113
scintigraphy, 113
studies (GES), 118
Gastric POEM (G-POEM), 98
efficacy and outcome of, 98
post-procedural care, 99
published data on, 99t
technique of, 98
Gastroesophageal junction (GEJ), 72
Gastroesophageal reflux disease (GERD), 34, 78
ARMS for, 34
after POEM, 80–81
POEM series with, 81t
PPI-refractory, 34
Gastrointestinal (GI) endoscopy
EMR (see Endoscopic mucosal resection (EMR))
ESD (see Endoscopic submucosal dissection
(ESD) techniques)
POEM (see Per-oral endoscopic myotomy (POEM))
POET (see Per-oral endoscopic tumor resection
(POET))
Gastroparesis, 112–113
diagnostic workup, 113–114
13
C breath testing, 113
gastric emptying scintigraphy, 113
wireless motility capsules (WMC), 113
treatment options
endoscopic treatment, 114 –115
medical treatment, 114
per-oral pyloromyotomy, 115–116
surgical treatment, 115
Gastroparesis cardinal symptom index (GCSI), 112
Gastrotomy closure methods, 17
endoloops, 22
endoscopic suturing methods, 21–22
hemostatic clips, 17–18, 18f
over-the-scope clip (OTSC), 18–21, 19f
Padlock Clip, 20, 20f
T-tags, 22
looped T-tag, 23f
Gastrotomy positioning, 176
H
Heller myotomy (HM), 72, 93, 96, 978
Hernia, 184
High-resolution esophageal manometry (HREM), 88
with esophageal pressure topography (EPT), 91
Hybrid flexible endoscopic approach, 216–217
Hybrid NOTES, 6, 24
in clinical setting, 281, 282, 284
Hybrid rigid laparoscopic approach, 216
Hybrid transvaginal appendectomy, 216
Hybrid transvaginal NOTES, 203, 204, 205, 280
one umbilical trocar and transvaginal multi-instrument
access port, 284
to pure transvaginal transition, 287–288
two umbilical and one transvaginal trocar, 283, 284f
Hypercontractile esophagus, 89, 91f. See also Jackham-
mer esophagus
I
Ileal pouch-anal anastomosis (IPAA), 253
Incisionless operating platform (IOP), 133
for POSE procedure, 133f
Insulated-tip knife (IT knife), 48
Intensive care unit (ICU) patients, 144
MV for, 144
NOTES diaphragm pacing in, 146–149
diaphragm electrodes, 149f
modified PEG, 147
percutaneous retrieval of electrodes, 148f
permanent and temporary DP electrode, 147f
T-fastener technique, 147
Intersphincteric resection (ISR), 245
Intragastric balloons (IGBs), 126
Elipse gastric balloon, 130–131, 130f
Obalon, 129–130
Orbera, 126–128, 127f
Reshape Duo, 128–129, 129f
Spatz3 Adjustable Balloon System, 131
Intraperitoneal onlay mesh (IPOM) technique, 184
J
Jackhammer esophagus, 88, 89, 91f
LES myotomy in, 95–96
Jejunostomy, 114, 115
pseudocystjejunostomy,
164, 165
K
Killian’s triangle, 104, 104f
L
Laparoscopic appendectomy, 212
Laparoscopic hybrid cholecystectomy, 202–204
closure of vagina, 203f
dissection of triangle of Calot, 203
EuroNOTES Clinical Registry results, 204–206
NOTES cholecystectomies, 205t, 206t
German DGAV Registry results, 206, 207, 207t
Hamburg results, 203–204
insertion of camera, 203f
overview of results, 206t
prophylactic antibiotics, 203
triangle of safety, 203
Laparoscopic pyloroplasty, 115
Laparoscopy, 280, 287, 288
Index 295
Lichtleiter, 174
Lift-and-cut biopsy, 30
Lone Star retractor, 262
Lower esophageal sphincter (LES) myotomy, 88
in patients with DES, 95–96
Lumen-apposing metal stent (LAMS), 155
outcome, 156–157
M
Macrolide antibiotics, 114
Magnetic resonance cholangiopancreatography (MRCP),
163
Marsupialization, 162
Mechanical ventilation (MV), 144
long-term mechanical ventilation, 149
NOTES diaphragm pacing in, 146–149
diaphragm electrodes, 149f
modified PEG, 147
percutaneous retrieval of electrodes, 148f
permanent and temporary DP electrode, 147f
T-fastener technique, 147
Metoclopramide, 114
Minimally invasive surgery, 9, 170, 230
advantages of, 222
natural orifice method, 14
NOTES (see also individual entries), 82, 174, 269,
280
cystgastrostomy, 162
pseudocystgastrostomy, 162, 170
POEM, 94, 99
transanal NOTES TME, 243, 246, 249, 253
Motility disorder of stomach. See Gastroparesis
N
Narrowband imaging (NBI), 49
Natural orifice specimen extraction (NOSE), 7,
244, 246
Natural Orifice Surgery Consortium for Advancement and
Research (NOSCAR), 2, 73
POEM White Paper, 73, 78
Natural orifice translumenal endoscopic surgery
(NOTES), ix, 72, 174, 243, 280, 269
access routes, 222
closure methods, 17–18
clips, 17–21
endoloops, 22
endoscopic suturing methods, 21–22
no closure, 17
T-tags, 22
complications, 24–25
equipment, 14–15, 15t
fundamentals of, 14
hernia repair, 8–9
history of, 2, 9
new NOTES, 82
luminal exit techniques, 15
direct incision, 15
PEG technique, 16
puncture and dilate, 15–16
tunneling methods, 16–17
POEM for (see Per-oral endoscopic myotomy
(POEM))
stapled cystgastrostomy, 162
anastomosis creation, 169, 169f
color Doppler interrogation, 167f
esophageal dilation balloon,
168, 168f
fluoroscopic guidance, 169, 169f
guidewire, 168, 168f
hemostasis, 169, 170f
pseudocyst puncture, 167
Soehendra stent extractor, 168, 168f
tips
maintaining access, 22–24
spatial orientation, 24
tissue retraction and triangulation, 24
improvising and off-label use of devices, 24
training, 14
transoral anastomosis, 169
transanal surgery, 7
transesophageal surgery, 7–8
transgastric surgery, 5– 7
hybrid NOTES, 6
Ponsky’s PEG tube, 5
as transgastric procedure, 192
transuretheral surgery, 8
transvaginal surgery, 3 –5
concept of, 4
potential barriers, 2–3
Nissen fundoplication, 112
Nonsteroidal anti-inflammatory drugs (NSAIDs), 114
NOTES appendectomy
hybrid NOTES, 212
pure NOTES, 212
surgical instruments, 218
NOTES diaphragm pacing, 146–149
diaphragm electrodes, 149f , 144
modified PEG, 147
percutaneous retrieval of electrodes, 148f
permanent and temporary DP electrode, 147f
T-fastener technique, 147
NOTES hernia repair
SILS, 185
technique, 186–187, 186f, 187f
endoscopic tacks, 188f
looped spinal needle technique, 188
mesh at necropsy, 189f
modified esophageal stent introducer, 187, 187f
transvaginal placement of mesh, 185, 186
NOTES laparoscopic sleeve gastrectomy, 222
equipment
endoscopic equipment, 223
laparoscopic equipment, 223
justification for, 222
296 Index
incisional hernias, 222
postoperative care, 227–228
preoperative workup/patient selection, 222–223
exclusion criteria, 223
inclusion criteria, 223
weight loss surgery, 222–223
technique
closure, 226–227
organ extraction, 226, 227f, 228
patient positioning and OR planning, 223–224, 224f
perioperative endoscopy, 224
sleeve gastrectomy, 225–226
transvaginal access/colpotomy, 224– 225, 225f
NOTES nephrectomy, 280
complications, 289
entry of hybrid NOTES, 281
instrumentation, 288–289
flexible forceps, 289f
postoperative care, 285–287
postoperative sexual function, 289–290
preclinical development of, 280–281
multitasking platforms, 281
robotic platforms, 281
pure NOTES nephrectomy, 281–282
recommendations, 290
robot-assisted, 282
surgical technique
hybrid transvaginal NOTES, 283–284, 284f
patient positioning, 283
port placement, 283
technical details of procedure,
284–285
specimen extraction through vagina, 286f
transvaginal approach, 282
consent, 283
contraindications, 282
indications, 282
preoperative evaluation, 283
preoperative preparation, 283
NOTES pancreatic debridement. See Pancreatic necrosis
and therapy
NOTES pseudocystgastrostomy, 170, 171
anastomosis creation, 169, 169f
color Doppler interrogation, 167f
esophageal dilation balloon, 168, 168f
fluoroscopic guidance, 169, 169f
guidewire, 168, 168f
hemostasis, 169, 170f
pseudocyst puncture, 167
Soehendra stent extractor, 168, 168f
transoral anastomosis, 169
NOTES transvaginal appendectomy, 212, 219
closure, 217
colpotomy closure, 217f
comparison
hybrid versus pure endoscopic appendectomy,
218–219
rigid versus flexible endoscopic appendectomy, 218
complications, 217–218
contraindications, 213
history, 212
hybrid appendectomy, 216
flexible endoscopic approach, 216–217
rigid laparoscopic approach, 216
transvaginal appendectomy, 216
indications, 212
operative approaches, 214
triangle of safety, 214f
positioning of
patient, 213–214
surgeon and assistant for, 213f
pure appendectomy
flexible endoscopic approach, 216
rigid laparoscopic approach, 215–216
transvaginal appendectomy, 214, 215f
recent outcome reports, 218
surgical instruments, 218
versus conventional laparoscopic appendectomy, 218
NOTES transvaginal cholecystectomy, 202, 208. See also
Laparoscopic hybrid cholecystectomy
advantage of, 202
Nutcracker esophagus, 93, 94
O
Obalon intragastric balloon, 129–130
Obesity, 122–123
cardiovascular disease, 123
endoscopic bariatric therapies (see also Endoscopic
bariatric therapies (EBTs)), 123–124
Open appendectomy, 212
Orbera intragastric balloon, 126–127, 127f
OverStitch for endoscopic sleeve gastroplasty, 131–132
P
Pancreatic necrosis and therapy
adverse events, 157–158
air embolism, 158
bleeding, 157, 158
infections, 158
stent migration, 158
alternative treatment strategies, 157
indications and timing of intervention, 152–153
procedural technique, 153
–154
adjunctive transpapillary stenting, 155
antibiotic therapy, 153
drainage, 153, 154, 155, 156, 157, 158
dual-modality therapy, 155
endoscopic retrograde cholangiopancreatography,
156
endoscopic ultrasound guidance, 154
lumen-apposing metal stent, 155
self-expandable metal stent, 154, 155f
Pancreatic pseudocyst, 162
anatomic considerations, 164–165
pseudocystduodenostomy, 164, 165
pseudocystgastrostomy, 164, 165, 165f
pseudocystjejunostomy, 164, 165
Index 297
strategy for drainage, 164
cystojejunal anastomosis, 162
diagnosis and workup, 162–163
computerized tomography, 162–163, 163f, 164f
endoscopic ultrasound, 163
MRCP, 163
indications for intervention, 163–164
types of treatment, 164
marsupialization, 162
NOTES technique, 167–170
anastomosis creation, 169, 169f
color Doppler interrogation, 167f
esophageal dilation balloon, 168, 168f
fluoroscopic guidance, 169, 169f
guidewire, 168, 168f
hemostasis, 169, 170f
pseudocyst puncture, 167
Soehendra stent extractor, 168, 168f
transoral anastomosis, 169
rationale
for endoscopic intervention, 166
percutaneous drainage, 165–166
for surgical intervention, 165–166
tools required, 166–167
Pancreatic pseudocystgastrostomy, 162
Pancreatitis therapy, adverse events, 157–158
air embolism, 158
bleeding, 157, 158
through-the-scope (TTS) endoclips, 158
infections, 158
stent migration, 158
Patient assessment of upper gastrointestinal disorders–
symptom severity index (PAGI-SYM), 112
Percutaneous endoscopic gastrostomy (PEG), 144, 174,
186
gastrotomy creation, 174–177, 176f
infectious implications, 178–179
insufflation of abdominal cavity, 177–178
visualization, 179–180
Perforations, 63
colonic wall perforation, 64
innovative approach, 68
Per-oral endoscopic myotomy (POEM), 7, 14, 37f, 62, 88,
115, 174
adverse events, 80
comparative analysis, 81
comparison to surgical myotomy, 40
development of, 72–73
efficacy, 40, 78–80, 79t
equipment, 74t
of esophagus, 35
bleeding, 39
follow-up, 39
indications, 35
insufflation, 39
perforation, 39–40
postprocedure care, 38–39
procedure,
36–38
safety, 39
technique, 35–36
view of angle of His, 37f
future of, 82
GERD after, 80–81, 81t
hybrid knife, 77f
indicators, 77–78
patient evaluation, 73
post-POEM reflex, 40
for SEDs, 93
modification of, 94–95
outcomes of, 96
published data on, 94t
reasons for using, 93–94
steps, 76f
technique, 73–78, 74f, 75f
training, 82
triangle-tip knife, 77 f
Per-oral endoscopic pyloromyotomy, 175. See also
Per-oral pyloromyotomy (POP)
Per-oral endoscopic tumor resection (POET), 40–41, 41f
efficacy, 42
indications, 41
safety, 41–42
technique, 41
Per-oral pyloromyotomy (POP), 115–116
future perspectives, 118
technical differences, 118
technique,
116
gastric emptying studies, 118
images, 117f
submucosal tunnel, 116f
upper GI series, 117f
Pomeroy technique, 238
Postsurgical gastroparesis (PSG), 112
Post-viral gastroparesis, 112
Primary obesity surgery endoluminal (POSE) procedure,
133–134, 133f
Proctectomy, 253, 255
benign indications, 254t
malignant indications, 255
Proton pump inhibitor (PPI), 34, 39, 80, 112, 117
PPI-refractory GERD, 34
Pure flexible endoscopic approach, 216
Pure rigid laparoscopic approach, 215–216
first transvaginal view of appendix, 215f
inspection of staple lines, 216f
placement of appendix, 216f
stapling of appendix, 215f
transumbilical view of SILS port, 215f
Pure transvaginal NOTES, 284
conditions necessary for progression to, 288
extra-long pre-bent instruments, 285f
stepwise transition from hybrid transvaginal NOTES,
287–288
three-channel port, 288, 290f
298 Index
R
Rectal adenoma, 253
colorectal ESD, 51
Rectal cancer, 245, 246
NOTES approach, 243
patient characteristics of taTME, 247–249t
robotic TME, 243
TEM, 245, 269
trails, 244
TES, 243
transanal proctectomy, 256
Refractory gastroparesis, 97
diagnosis, 97
therapies for, 97–98
Reshape Duo intragastric balloon, 128–129
Revita duodenal mucosal resurfacing, 136, 137f
Robotic-assisted surgical devices, 184
Robotic versus Laparoscopic Resection for Rectal Cancer
(ROLARR) trial, 243, 244
Roux-en-Y gastric bypass (RYGB), 178, 179
S
Self-assembling magnets, 136
Self-expandable metal stent (SEMS), 154, 155f
outcome, 156–157
Single-incision laparoscopic surgery (SILS), 185
Sleeve gastrectomy, 225–226. See also NOTES laparo-
scopic sleeve gastrectomy
final evaluation, 226f
placing staples, 226f
planned stapler routes for, 225f
Society of American Gastrointestinal Endoscopic Sur-
geons (SAGES), 2, 4
Spastic esophageal disorders (SEDs), 88
clinical manifestations of, 89–90
DES, 89
diagnostic work-up for,
90
barium swallow, 90–91
CT scan, 91–92
endoscopic ultrasound, 91–92
HREM with EPT, 91
24-h pH monitoring, 91
upper endoscopy, 90
EGJOO, 89
high-resolution patterns of, 92t
spastic achalasia, 89
treatment of, 92
endoscopic therapy, 92–93
pharmacological therapy, 92
POEM for, 93
surgical therapy, 93
Spatz3 Adjustable Balloon System, 131
Sphincter preserving surgery, 243, 276
proctectomy, 256
restorative proctectomy, 246
TEM, 245, 269
TME, 243, 270
Spinal cord injury (SCI) patients, 144
MV for, 144
Strip biopsy, 30
Strip-off biopsy, 30
Subepithelial tumor (SET), 42
POET in, 41
safety, 41–42
technique, 41
Submucosal tunnel, 72, 78
creation of, 75f
as POEM step, 76f
Submucosal tunnel endoscopic resection (STER), 82
T
Therapeutic endoscopy
POEM (see Per-oral endoscopic myotomy (POEM))
POET (see Per-oral endoscopic tumor resection
(POET))
Therapeutic irrigation, 155, 156
Total abdominal hysterectomy (TAH), 231
–232
Total mesorectal excision (TME), 243, 244, 270
Tracheostomy, 145, 149, 150
Transanal colectomy, 245–246
Transanal endoscopic microsurgery (TEM), 7, 245, 269
equipment
endosurgical unit, 271
long-handled instruments, 271, 272f
rectoscope, 271, 272f
stereoscope, 271, 272f
indications, 270
operative technique, 273
closure of defect, 274, 276f
insufflation, 274, 275f
marking of lesion, 274f
marking suture placement, 274, 275f
position of patient, 273f
surgical team setup, 274f
transection, 274
outcome, 276
technical variation, 275– 276
treatment algorithm, 271f
workup
endoscopic rectal ultrasound, 270
flexible sigmoidoscopy and rigid proctoscopy, 270
full colonoscopy, 270
full history and physical examination, 270
preoperative imaging, 270
preoperative laboratory studies, 270
Transanal endoscopic operating system (TEO), 244
Transanal endoscopic surgery (TES), 243
Transanal minimally invasive surgery (TAMIS), 7, 245,
246, 258, 264
Transanal NOTES
digital rectal examination, 256
even extralevator abdominoperineal excision, 256
instrumentation, 258
operative setup, 257–258, 257f
patient selection, 256
preoperative assessment and staging, 256
Index 299
preoperative preparation, 256– 257
Transanal surgery, 7
Transanal total mesorectal excision (taTME), 243, 246,
249, 253
benign indications, 253, 254t, 255
patient characteristics of, 247–249t
postoperative outcomes of, 250–252t
procedural steps for, 258–261
anterior mesorectal dissection, 260f
complete TME specimen, 262f
handsewn coloanal anastomosis, 261f
laparoscopic view of peritoneal entry, 260f
lateral mesorectal dissection, 260f
posterior mesorectal dissection, 259f
purse-string occlusion, 259f
purse-string suture placement, 259f
rectal transanal dissection, 259f
transanal specimen extraction, 261f
transanal view of peritoneal entry, 260f
view through plastic anoscope, 259f
Transanal transabdominal (TATA) method, 244, 245, 246
advantages of, 245
indications for, 246
Transesophageal surgery, 7–8
Transgastric appendectomy, 212
Transgastric endoscopic groin dissection, 189
Transgastric endoscopic peritoneoscopy (TEP), 175
Transgastric surgery, 5–7
hybrid NOTES, 6
transgastric pancreatocystogastrostomy, 5
transgastric peritoneoscopy, 5
, 6–7
transgastric splenectomy, 6
Transillumination auxiliary technique, 78
Transmural drainage, 162, 165
Trans-pyloric stenting (TPS), 98
Transsphenoidal surgery, 8
Transurethral resection of the prostate (TURP), 8
Transurethral surgery, 8
Transvaginal abdominal access, 214, 215f
Transvaginal cholecystectomy, 192–193
advantage of, 192
anatomic considerations, 193
content process, 193
technique, 193–194
critical view of safety, 195
EndoGrab laparoscopic applier, 195f
gallstones retrieval, 196, 197f
modified hook electrocautery, 196f
NovaTract dynamic retractor, 194, 196f
suture retraction, 194, 194f
Zimmon needle knife, 194
transvaginal hybrid cholecystectomies, 197
NOSCAR trial, 197, 198
NOVEL (Natural Orifice VErsus Laparoscopy) trial,
197, 198, 199
Roth Net retrieval device, 197
vagina–promontory (V-P) line, 192
Transvaginal hybrid NOTES technique, 202
Transvaginal hydrolaparoscopy (THL), 238
Transvaginal NOTES nephrotomy, 282
consent, 283
contraindications, 282
indications, 282
patient positioning, 283
Transvaginal organ extraction,
226–227
repair of colpotomy, 227f
vaginal extraction, 227f
Transvaginal sterilization, 238
Transvaginal surgery, 235– 236. See also Vaginal hys-
terectomy (VH)
complications, 239
diagnostic culdoscopy, 238
history, 236
procedure, 236–238
transvaginal sterilization, 238– 239
Transvaginal surgery, 3–5
colpotomy, 3
transvaginal appendectomy, 4–5
transvaginal cholecystectomy, 4
transvaginal oophorectomy, 4
transvaginal tubal ligation, 3–4
vaginal hysterectomy, 3
ventroscopy, 3
Transvaginal surgery. See Laparoscopic hybrid
cholecystectomy
Tricyclic antidepressants, 114
Tubal ligation, 3, 6, 233
V
Vaginal hysterectomy (VH), 230
anemia, 231
complications, 235
contraindications to, 230
endometrial sampling, 231
history, 231–232
Pap smear, 231
procedure, 232
anterior colpotomy, 234f
anterior incision, 233
cystoscopy, 234
descending uterus, 233, 235f
oophorectomy, 234
positioning for, 232
f
posterior colpotomy, 233f
vaginal cuff closure, 234
Ventilator-induced diaphragm dysfunction (VIDD), 144
Ventroscopy. See Culdoscopy
Video-assisted retroperitoneal debridement (VARD), 157
W
Walled-off necrosis (WON), 152
adverse events, 157–158
air embolism, 158
bleeding, 157, 158
infections, 158
stent migration, 158
300 Index
alternative treatment strategies, 157
CT scan of, 152f
direct endoscopic necrosectomy procedures, 153
fine needle aspiration, 153
advantage of, 154
Z
Zenker’s diverticulum (ZD)
advantages of, 107
background, anatomy, definition, 104
clinical manifestations of, 104–105
Hook Knife in, 109
management
flexible endoscopic, 105–107, 106f
open surgical, 105
rigid endoscopic, 105
porcine model, 108
Index 301