title: Natural orifice translumenal endoscopic surgery: radical prostatectomy in the canine model.
abstract: OBJECTIVE
  The goal of this study is to demonstrate the feasibility of transurethral radical prostatectomy in the canine model. We describe the surgical procedure for natural orifice translumenal endoscopic surgery-radical prostatectomy (NOTES-RP).
  
  
  METHODS
  NOTES-RP was performed on six nonsurvival male canines. The 100 watt holmium:yttrium-aluminum-garne laser, 550 μm end-firing fiber, 28F laser resectoscope, 7F stabilizing catheter, and continuous irrigation were used to radically resect the prostate. A Vest vesicourethral anastomosis was performed using a laparoscopic suture device that was delivered through the nephroscope. In the initial cases, the prostate was removed manually; for the last two cases, the prostate was removed endoscopically with a tissue morcellator.
  
  
  RESULTS
  NOTES-RP was successfully executed in all canines. Visualization was not obscured by bleeding. Dissection times ranged from 40 to 120 minutes. Fluid absorption was problematic in cases lasting more than 1 hour, because of the intraperitoneal location of the canine prostate and bladder.
  
  
  CONCLUSIONS
  The feasibility and technique of NOTES-RP was successfully demonstrated in the living canine model.
authors.affiliation: Methodist Hospital Institute for Kidney Stone Disease, Indianapolis, Indiana 46202, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Krambeck
authors.forename: Mitchell R
authors.initials: MR
authors.lastname: Humphreys
authors.forename: Paul E
authors.initials: PE
authors.lastname: Andrews
authors.forename: James E
authors.initials: JE
authors.lastname: Lingeman
mesh_terms: D000818:Animals; D053844:Lasers, Solid-State; D008297:Male; D023421:Models, Animal; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D010030:Ostomy; D011467:Prostate / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*