title: Transgastric cholecystectomy: From the laboratory to clinical implementation.
abstract: After the first report by Kalloo et al on transgastric peritoneoscopy in pigs, it rapidly became apparent that there was no room for an under-evaluated concept and blind adoption of an appealing (r)evolution in minimal access surgery. Systematic experimental work became mandatory before any translation to the clinical setting. Choice and management of the access site, techniques of dissection, exposure, retraction and tissue approximation-sealing were the basics that needed to be evaluated before considering any surgical procedure or study of the relevance of natural orifice transluminal endoscopic surgery (NOTES). After several years of testing in experimental labs, the revolutionary concept of NOTES, is now progressively being experimented on in clinical settings. In this paper the authors analyse the challenges, limitations and solutions to assess how to move from the lab to clinical implementation of transgastric endoscopic cholecystectomy.
authors.affiliation: Bernard Dallemagne, Silvana Perretta, Pierre Allemann, Gianfranco Donatelli, Mitsuhiro Asakuma, Didier Mutter, Jacques Marescaux, Department of Digestive and Endocrine Surgery, Pôle Hépato-Digestif, University Hospital of Strasbourg and IRCAD, 67091 Strasbourg Cedex, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Dallemagne
authors.forename: Silvana
authors.initials: S
authors.lastname: Perretta
authors.forename: Pierre
authors.initials: P
authors.lastname: Allemann
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Donatelli
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Asakuma
authors.forename: Didier
authors.initials: D
authors.lastname: Mutter
authors.forename: Jacques
authors.initials: J
authors.lastname: Marescaux