title: Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port.
abstract: OBJECTIVE
  To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or not.
  
  
  METHODS
  Two dogs (11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port.
  
  
  RESULTS
  The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one port.
  
  
  CONCLUSIONS
  We are sure of great feasibility of endoscopic cholecystectomy via single port for human.
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Mori
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kobara
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishiyama
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Fujihara
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Taiga
authors.initials: T
authors.lastname: Chiyo
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Ayaki
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagase
authors.affiliation: Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
mesh_terms: D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002763:Cholecystectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D004285:Dogs; D019723:Endoscopes; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D023421:Models, Animal; D061646:Operative Time; D018583:Pliability; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors
keywords: Endoscopic cholecystectomy; Feasibility; Laparoscopic and endoscopic cooperative surgery; Safer and complete resection; Single port