Lee Swanstrom

..Next, we will review the early experiences with robot-assisted minimally invasive colon resections. Lastly, we will introduce the next frontier in minimally invasive surgery, natural orifice transluminal endoscopic surgery (NOTES)...

..This technology may serve as the needed platform for transgastric cholecystectomy, gastric reduction, fundoplication, hiatus hernia repair, or other advanced endosurgical procedures...

..The issues of access and platform stability, laparoscopic-like instruments, and secure tissue approximation are described, and the devices to solve these issues are detailed...

..Natural orifice translumenal endoscopic surgery (NOTES) has theoretical patient advantages. Because public attitude toward NOTES will influence its adoption, this study aimed to assess patients' opinions regarding the NOTES procedure...

..We present early results of a series of acute animal experiments studying the feasibility of using flexible endoscopes for complex esophageal surgery such as Heller myotomy and esophagectomy...

..In the long run, computer interfaces may be necessary to resolve some of these human factor issues and make a true universal platform...

..NOTES is a potential advance in surgical care. This new approach requires the development of new platform devices, tailored to allow the safe and effective practice of this advanced endoscopic approach...

..In an effort to bring order to this chaotic situation, the Minimally Invasive Surgery Fellowship Council (MISFC) was founded in 1997...

..The FLS assessment includes a multiple-choice cognitive test and a manual skills test. We present the results of validation studies of this novel assessment tool...

..We describe the development of an endoscopic system specifically designed for endoluminal and NOTES procedures and demonstrates benefits and efficacy in benchtop and cadaver models...

..The authors report their results using these four separate surgical approaches tailored to three different therapeutic procedures, all with the use of a single flexible platform, the Incisionless Operating Platform (IOP)...

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..This technique has been used clinically in human beings for more than 2 decades. Entry into the peritoneal cavity during a resection of rectosigmoid lesions has been described, and safe closure can be obtained...

..If proven feasible and safe, Natural Orifice Translumenal Endoscopic Surgery (NOTES) would still need acceptance by surgeons if it were to become a mainstream approach...

..Our aim was to demonstrate the feasibility of performing both pouch and stomal reduction using transoral endoscopically placed tissue anchors in an ex vivo and acute animate model...

..We present a novel and safe technique for creating a gastrotomy developed in our animal laboratory and applied in all of our human NOTES cholecystectomies...

..Gastrogastric fistulas (GGFs) are seen in 1.5% to 12.5% of patients after Roux-en-Y gastric bypass (RYGB) bariatric surgery, often leading to failure to lose adequate weight...

..The devices used for natural orifice transluminal endoscopic surgery procedures are endoscopes or inspired by endoscopic design, which makes it difficult to accomplish bimanual coordination...

..We prospectively compared anterior fundoplication (Dor) with partial posterior fundoplication (Toupet) in patients undergoing laparoscopic Heller myotomy...

..Our objective was to assess the necessity for endoscope sterilization for clinical NOTES and to develop an endoscope processing protocol based on a score for the available processing options...

..All other patients are symptom free with no signs of stricture or recurrent biliary obstruction. CONCLUSIONS: Laparoscopic biliary reconstruction represents a viable treatment option in carefully selected patients...

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..We hypothesize that there are objective criteria that will identify those patients who will have a normal DeMeester score (DMS) following endoluminal treatment...

..More liberal application of Collis gastroplasty in these patients is not warranted...

..The procedural goal is to decrease the high overall morbidity of a traditional open esophageal resection. The entire spectrum of open esophagectomy techniques has been successfully replicated in a minimally invasive fashion...

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..We predicted that the surgeons in a team that has longer teamwork experience would perform more anticipatory movements than surgeons in a surgical team that is newly formed...

..In the operating room (OR), nurse-surgeon coordination is essential to the success of a surgery...

..In this article, we describe three new devices in development or newly on the market that are targeted to advance the safe endoscopic closure of gastrotomy from NOTES...

..The purposes of this study were to assess outcomes in patients operated on for failed ARS, to describe reasons for failure of the primary surgery, and to identify factors predictive of failure of the revision...

..Lesions likely to be above the peritoneal reflection and within reach of the endoscope (4 to 24 cm) should be considered for TEM excision...

..This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0-24%). However, mesh complications have been observed...

..Verbal communication, especially the instructions and feedback from an experienced instructor, improved team efficiency and performance...

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..We report our multicenter intraoperative experience and postoperative follow-up to date using the Incisionless Operating Platform for this patient subset...

..Removal of the functional esophageal outlet obstruction, as with a surgical myotomy, may be necessary to obtain significant peristalsis with vagal pacing in severe achalasia...

..Outcomes in patients having surgery for gastroesophageal reflux disease are most commonly determined by symptomatic assessment. Objective testing is usually reserved for symptomatic patients...

..These criteria can be employed when evaluating upper gastrointestinal complaints after antireflux surgery and may ultimately serve as a dependable outcome measure...

..CONCLUSIONS: Patients with bipositional reflux have the most severe disease. Supine, upright, and bipositional reflux patients perform equally well following laparoscopic fundoplication as defined by objective outcome criteria...

..Team size and composition provide essential data for the study of operating room (OR) efficiency...

..Many activities performed by team members in the operating room (OR) are not directly related to the achievement of the surgical goal...

..Iatrogenic trauma accounts for almost 20% of all chyle leaks, and esophagectomy is the most common iatrogenic cause. Consequences of ongoing chyle leak include dehydration, malnutrition, and immunocompromise...

..5 months. CONCLUSIONS: LHAIP placement is technically feasible, and variant HA is not associated with increased pump complications or decreased pump functional time...

..Exposure to laparoscopy influences survival in patients with unresected pancreatic cancer who have a diagnostic or staging surgical procedure...