title: Feasibility of endoscopic transoral thoracic surgical lung biopsy and pericardial window creation.
abstract: BACKGROUND
  The thoracic cavity approach for natural orifice transluminal endoscopic surgery (NOTES) is technically challenging. The aim of this study was to evaluate the feasibility of a transoral endoscopic technique for a surgical lung biopsy and pericardial window creation
  
  
  METHODS
  Under general anesthesia, a 12 mm incision was made over the vestibulum oris region. Under video guidance, a homemade metallic tube was introduced through the incision, extending along the pre-tracheal space to the substernal space with blunt dissection technique, and used as the entrance into the thoracic cavity. A surgical lung biopsy and a pericardial window creation were performed in 12 canines, using the transoral NOTES technique.
  
  
  RESULTS
  The transoral endoscopic surgical lung biopsy and pericardial window creation were successfully completed in 11 of the 12 canines. Intraoperative bleeding and death from an injury to the pulmonary hilum developed in one animal during the electrosurgical excision of lung tissue.
  
  
  CONCLUSIONS
  Transoral surgical lung biopsy and pericardial window creation in canine models is technically feasible and can be used as a novel experimental platform for studies of NOTES for intra-thoracic surgery.
authors.affiliation: Laboratory Animal Center, Department of Surgery, Chang Gung Memorial Hospital at Linko, Chang Gung University, China.
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
authors.forename: Yen
authors.initials: Y
authors.lastname: Chu
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.forename: Chieng-Ying
authors.initials: CY
authors.lastname: Liu
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Tzu-Ping
authors.initials: TP
authors.lastname: Chen
authors.forename: Yin-Kai
authors.initials: YK
authors.lastname: Chao
authors.forename: Ching-Yang
authors.initials: CY
authors.lastname: Wu
authors.forename: Hsu-Chia
authors.initials: HC
authors.lastname: Yuan
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Liu
mesh_terms: D000818:Animals; D001706:Biopsy; D004285:Dogs; D005240:Feasibility Studies; D008168:Lung / Q000473:pathology* / Q000601:surgery; D023421:Models, Animal; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D010491:Pericardial Window Techniques; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome