title: New detachable occlusion balloon unit for transrectal natural orifice translumenal endoscopic surgery.
abstract: BACKGROUND
  Transrectal natural orifice translumenal endoscopic surgery (NOTES) requires a good endoluminal view and adequate intrarectal bacterial clearance in the working area. We developed a new occlusion balloon unit with an easily detachable inflation device, which allows the surgeon a clear working area distal to the balloon.
  
  
  METHODS
  The effectiveness of the sealing balloon and the extent of macroscopic and histopathological injury to the bowel wall at the site of balloon placement were examined in 12 pigs.
  
  
  RESULTS
  The mean time to place and inflate the balloon unit was 12.0 ± 3.5 min, effective air-tightness lasted for 21.0 ± 12.0 min. There was no leakage of dye (methylene blue) past the balloon when pressure was maintained >6.70 ± 0.08 kPa (6.62-6.78 kPa). After gut irrigation, good visibility was maintained in the working area for six hours, and adequate bacterial clearance was maintained for three hours. There were no macroscopic signs of intestinal wall damage at the site of balloon placement. Histopathological examination showed only patchy mucosal damage and submucosal thrombus at the site of balloon placement.
  
  
  CONCLUSIONS
  This newly-developed occlusion balloon unit helps to establish good visibility and adequate bacterial clearance for endoluminal surgical procedures.
authors.affiliation: Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. jokyo@dem.med.kyushu-u.ac.jp
authors.forename: Hao
authors.initials: H
authors.lastname: Xu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ohdaira
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nagao
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsutsumi
authors.forename: Megumu
authors.initials: M
authors.lastname: Mori
authors.forename: Munenori
authors.initials: M
authors.lastname: Uemura
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Toyoda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ieiri
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashizume
mesh_terms: D000818:Animals; D001419:Bacteria / Q000378:metabolism; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D004396:Coloring Agents / Q000737:chemistry; D004867:Equipment Design; D005260:Female; D007413:Intestinal Mucosa / Q000473:pathology*; D008751:Methylene Blue / Q000737:chemistry; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation / Q000379:methods*; D012007:Rectum; D013552:Swine; D013927:Thrombosis / Q000209:etiology / Q000473:pathology; D013997:Time Factors
chemical_list: D004396:Coloring Agents; D008751:Methylene Blue