Diagnostic pure transgastric NOTES in an intensive therapy unit patient

Maciej Michalik; Maciej Bobowicz; Anna Trybull; Mieczysław Witzling

doi:10.5114/wiitm.2011.23220

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abstract:

Case report

Diagnostic pure transgastric NOTES in an intensive therapy unit patient

Maciej Michalik

,

Maciej Bobowicz

,

Anna Trybull

,

Mieczysław Witzling

Videosurgery and other miniinvasive techniques 2011; 6 (2): 108-110

DOI: https://doi.org/10.5114/wiitm.2011.23220

Online publish date: 2011/07/08

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Natural orifice transluminal endoscopic surgery (NOTES) is a natural consequence of evolution in minimally invasive surgery. It allows one to reduce surgical trauma and the number of complications and to improve cosmetic outcomes. It also shortens the patient’s recovery time. So far there have been only nine NOTES procedures performed in Poland and around 200 NOTES interventions performed worldwide. In this paper a transgastric diagnostic NOTES procedure in a critically ill patient is described. A 60-year-old male patient with multi-organ failure (circulatory, respiratory and renal insufficiency, with co-morbid hypothyroidism and diabetes mellitus) hospitalized in the intensive therapy unit (ITU) with unknown cause of his condition was qualified for transgastric diagnostic NOTES procedure. This intervention revealed the diagnosis of metastatic neoplastic disease and allowed persistent therapy to be avoided. Diagnostic NOTES in selected patients seems to be a very useful. It provides fast diagnosis with relatively small perioperative trauma. It is an easy procedure that requires a regular or operative endoscope, one surgeon and an endoscopic nurse. It can be done anywhere, including at the patient’s bedside. It provides specimens for histopathology and speeds up diagnostics and decision making, especially in terminally ill patients.

keywords:

natural orifice transluminal endoscopic surgery (NOTES), diagnostic NOTES, transgastric NOTES, pure NOTES, scar-free surgery, minimally invasive surgery

Diagnostic pure transgastric NOTES in an intensive therapy unit patient

Maciej Michalik , Maciej Bobowicz , Anna Trybull , Mieczysław Witzling

natural orifice transluminal endoscopic surgery (NOTES), diagnostic NOTES, transgastric NOTES, pure NOTES, scar-free surgery, minimally invasive surgery

Maciej Michalik

,

Maciej Bobowicz

,

Anna Trybull

,

Mieczysław Witzling