Peritoneal access, transgastric peritoneoscopy and oophorectomy - feasibility study on an experimental Swine model.

BACKGROUND/AIMS: Natural orifice translumenal endoscopic surgery (NOTES) still poses numerous challenges, even in cases of relatively simple surgical procedures. This study aims to assess the feasibility of transgastric resectional interventions using commonly available endoscopic equipment as well as to offer a safe closure method of the gastric access site. METHODOLOGY: Ten pigs underwent pure transgastric endoscopic oophorectomy using a single channel endoscope. The gastric defect was closed using over-the-scope clips (OTSC™, OVESCO Endoscopy). After 2 weeks the animals underwent autopsies. RESULTS: All procedures were successful. Transgastric access time varied from 4.46 to 33.24 minutes. The peritoneal exploration took 31 minutes and oophorectomy needed in average of 21 minutes (range 15-28 minutes). The animals for which the gastric access site was closed with OTSC™ survived for 2 weeks without complications. CONCLUSION: This study demonstrates the technical feasibility and safety of pure transgastric endoscopic oophorectomy using conventional endoscopic instrumentation in a porcine model. OTSC™ closure system is an easy to use and reliable gastric closure method.