Although natural orifice specimen extraction is now relatively widely performed, there have been no reports on gastric resection with specimen extraction through the transgastric route for peptic ulcer disease. A hybrid technique of the laparoscopic and endoscopic approach is presented in the case of a 58-year old male patient. Preoperative gastric fibroscopy showed postulcer pyloric and antral stenosis. Laparoscopic exploration confirmed gastric enlargement. Laparoscopic two-thirds gastrectomy was performed. The staple line suture of the residual stomach was excised and the specimen was extracted through the esophagus and mouth with a gastroscope. Finally, the residual stomach was closed again using linear endostaplers. Reconstruction was performed according to the Roux-en-Y method. Gastric resection using natural orifice specimen extraction (NOSE) may be a feasible operative procedure. The NOSE with the combination of standard laparoscopy and specimen extraction through a natural orifice can be considered as a bridge to natural orifice translumenal endoscopic surgery.

Department of Surgery Municipal Hospital Ostrava Fifejdy Czech Republic

Department of Surgery University Hospital Hradec Kralove Czech Republic

Department of Surgery University Hospital Ostrava Czech Republic ; Department of Surgery Faculty of Medicine University of Ostrava Czech Republic

Zobrazit více v PubMed

Raymond TM, Dastur JK, Khot UP, Parker MC. Hospital stay and return to full activity following laparoscopic colorectal surgery. JSLS. 2008;12:143–9. PubMed PMC

Hackert T, Uhl W, Buchler MW. Specimen retrieval in laparoscopic colon surgery. Dig Surg. 2002;19:502–6. PubMed

Palanivelu C, Rangarajan M, Jategaonkar PA, Anand NY. An innovative technique for colorectal specimen retrieval: a new era of „Natural Orifice Specimen Extraction“ (N.O.S.E.) Dis Colon Rectum. 2008;51:1120–4. PubMed

Ooi BS, Quah HM, Fu CWP, Eu KW. Laparoscopic high anterior resection with natural orifice specimen extraction (NOSE) for early rectal cancer. Tech Coloproctol. 2009;13:61–4. PubMed

Kurpiewski W, Pesta W, Kowalczyk M, et al. The outcomes of SILS cholecystectomy in comparison with classic four- trocar laparoscopic cholecystectomy. Videosurgery Miniinv. 2012;7:286–93. PubMed PMC

Pedziwiatr M, Matlok M, Major P, et al. Laparoscopic surgery of the spleen through single umbilical incision. Videosurgery Miniinv. 2013;8:8–12. PubMed PMC

Ryska O, Martinek J, Filipkova T, et al. Single loop- and- clips technique (KING closure) for gastrotomy closure after transgastric ovariectomy: a survival experiment. Videosurgery Miniinv. 2012;7:233–9. PubMed PMC

Kalloo AN, Singh VK, Jagannath SB, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7. PubMed

Swain P. Nephrectomy and natural orifice translumenal endoscopy (NOTES): trans-vaginal, transgastric, transrectal and transvesical approaches. J Endourol. 2008;22:811–8. PubMed

Franklin ME, Ramos R, Rosenthal D, Schuessler W. Laparoscopic colonic procedures. World J Surg. 1993;17:51–6. PubMed

Delvaux G, Devroey P, De Waele B, Willems G. Transvaginal removal of gallbladders with large stones after laparoscopic cholecystectomy. Surg Laparosc Endosc. 1993;3:307–9. PubMed

Gill IS, Cherullo EE, Meraney AM. Vaginal extraction of the intact specimen following laparoscopic radical nephrectomy. J Urol. 2002;167:238–41. PubMed

Yuan LH, Chung HJ, Chen KK. Laparoscopic radical cystectomy combined with bilateral nephroureterectomy and specimen extraction through the vagina. J Chin Med Assoc. 2007;70:260–1. PubMed

Jeong SH, Lee YJ, Choi WJ, et al. Trans- vaginal specimen extraction following totally laparoscopic subtotal gastrectomy in early gastric cancer. Gastric cancer. 2011;14:91–6. PubMed

Nakajima K, Takahashi T, Souma Y, et al. Transvaginal endoscopic partial gastrectomy in porcine models: the role of an extra endoscope for gastric control. Surg Endosc. 2008;22:2733–6. PubMed

Lacy AM, Delgado S, Rojas OA, et al. Hybrid vaginal MA-NOS sleeve gastrectomy: technical note on the procedure in a patient. Surg Endosc. 2009;23:1130–7. PubMed

Kantsevoy SV, Jagannath SB, Niiyama H. Endoscopic gastrojejunostomy with survival in porcine model. Gastrointest Endosc. 2005;62:287–92. PubMed

Jagannath SB, Kantsevoy SV, Vaughn CA. Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model. Gastrointest Endosc. 2005;61:449–53. PubMed

Park PO, Bergstrom M, Ikeda K, et al. Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis (videos) Gastrointest Endosc. 2005;61:601–6. PubMed

Kantsevoy SV, Hu B, Jagannath SB, et al. Transgastric endoscopic splenectomy. It is possible? Surg Endosc. 2006;20:522–5. PubMed