Surgical Endoscopy

, 23:2827 | Cite as

A novel use of T-tag sutures for the safe creation and closure of the NOTES gastrotomy using a hybrid technique

  • R. C. T. AustinEmail author
  • C. A. Mosse
  • P. Swain
Dynamic Manuscript


Transgastric Natural Orifice Translumenal Endoscopic Surgery (NOTES) procedures are presently limited by the lack of a reliable method for creating and closing the gastrotomy created during the procedure. Furthermore, due to difficulties with the NOTES technique, the majority of NOTES procedures are presently performed in a “hybrid” fashion in which some degree of laparoscopic assistance is used alongside the NOTES approach. We describe a hybrid approach with a minimal laparoscopic component allowing a very controlled gastrotomy creation and closure. This technique would also allow laparoscopic suturing through a single, small cannula.


Natural Orifice Translumenal Endoscopic Surgery NOTES Transgastric surgery Gastrotomy 



We very gratefully acknowledge the generous loan of microlaparoscopic equipment from the Karl Storz Company in support of this work. R. Austin gratefully acknowledges receipt of a grant from the EURO-NOTES Foundation 2008.

Supplementary material

Supplementary material 1 (WMV 11929 kb)


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of General SurgeryColchester General HospitalColchesterUK
  2. 2.Department of Medical PhysicsUniversity CollegeLondonUK
  3. 3.Department of BioSurgery and Surgical Technology, Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Faculty of MedicineImperial CollegeLondonUK

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