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

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Abstract

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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Department of General Surgery, Colchester General Hospital, Turner Road, Colchester, Essex, CO4 5JL, UK

    R. C. T. Austin

  2. Department of Medical Physics, University College, Malet Place Engineering Building, Gower Street, London, WC1E 6BT, UK

    C. A. Mosse

  3. Department of BioSurgery and Surgical Technology, Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Faculty of Medicine, Imperial College, QEQM Building, South Wharf Road, London, W2 1NY, UK

    P. Swain

Authors
  1. R. C. T. Austin
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  2. C. A. Mosse
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  3. P. Swain
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Corresponding author

Correspondence to R. C. T. Austin.

Additional information

P. Swain and C. A. Mosse are consultants for Ethicon EndoSurgery, Cincinnati, Ohio, USA.

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Austin, R.C.T., Mosse, C.A. & Swain, P. A novel use of T-tag sutures for the safe creation and closure of the NOTES gastrotomy using a hybrid technique. Surg Endosc 23, 2827–2830 (2009). https://doi.org/10.1007/s00464-009-0635-8

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  • DOI: https://doi.org/10.1007/s00464-009-0635-8

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