Intraoperative NOTES endosonography and identification of mock hepatic lesions.
OBJECTIVE
Intraoperative ultrasound is commonly used during standard transabdominal surgery. The feasibility of endoscopic ultrasound (EUS) through Natural Orifice Translumenal Endoscopic Surgery (NOTES) for identification of abdominal lesions with a flexible echoendoscope has not been studied.


OBJECTIVE
To test the feasibility of NOTES-EUS for abdominal exploration and identification of mock hepatic lesions.


METHODS
Five pigs underwent transvaginal or transcolonic NOTES and endosonographic exploration. In 3 anesthetized pigs, mock hepatic lesions were created and NOTES-EUS was then performed to identify these mock lesions. Necropsy was performed in all cases.


RESULTS
All target organs were consistently identified by NOTES-EUS in all animals. Mock hepatic lesions were successfully created in 3 animals and were able to be located by NOTES-EUS. No complications were observed at necropsy.


CONCLUSIONS
Abdominal exploration and localization of mock lesions by NOTES-EUS is technically feasible. As natural orifice surgery evolves, intraoperative NOTES-EUS would be an essential addition to the NOTES armamentarium.
Division of Gastroenterology, University of Florida, Gainesville, FL 32610, USA.
Christopher J
CJ
Fyock
Tejas S
TS
Kirtane
Chris E
CE
Forsmark
Mihir S
MS
Wagh
D000818:Animals; D019160:Endosonography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D007430:Intraoperative Care; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D034421:Sus scrofa