The Application Of NOTES In Abdominal Exploration In The Animal Experimental Study

Background:The doctors always used abdominal exploration in examination andtreatment abdominal diseases.Many surgeons in the clinical work will occasionally meetunexplained abdominal pain and not sure the diagnosis and suspicious intra-abdominalmass.At present,a lot of the clinical noninvasive inspection,such as the abdominal ultrasoundexamination,CT and MR not good at diagnosis tiny lesions,they Can only found5-10mm indiameter of intra-abdominal mass and the auxiliary examination results can’t qualitative,onlya hint role.It is easy to make small lesions misdiagnosis and missed diagnosis,tumors astuberculous peritonitis,the tumor which transfer to peritoneal tumors and these patients oftenmanifestation nonspecific clinical manifestation.Conventional medical examination can’tmake a timely and accurate diagnosis.Especially for ascites patients which can’t find thereason.This is not only easy to delay disease diagnosis, but also aggravate the patienteconomic burden.In this situation,abdominal exploration is seen as a very effective andimportant way to help doctors make clear diagnosis.There are many ways of abdominal exploration,in those ways of exploratorylaparotomy,laparoscopic abdominal exploration in the technology has been very mature.Butusing NOTES in abdominal exploration is a new and developing way.Showing its uniqueadvantage in the abdominal cavity detection and targeted biopsy.The study in this articlebased on Predecessors’ experience,in the existing technology and conditions utilization of thepig model to make evaluation of the feasibility and directional biopsy value use NOTES inabdominal exploration.Objective:Abdominal exploration and targeted biopsy is a very effectively method intargeted biopsy abdominal disease diagnosis,the traditional way of abdominal explorationhave too many defects,such as too much damage, high costs, so the patient unable tobear.This study purpose is evaluation the feasibility and biopsy application value withNOTES.Method:According to the different way random numbers of three experimental sows andprepare for the operation.Preoperative give depth anesthesia，monitoring ECG and bloodoxygen,Performer respectively from the stomach,vaginal and bowel into abdomen,carry out Exploration to protocol viscera,take the biopsy and pictures.Immediately anatomy afterabdominal exploration, take pictures of organs.Results： Experimental animals after fasting and drug treatment make thegastrointestinal tract emptying well.In protocol position successfully completed creates road,not occurred bleeding.Different road into the celiac in time-consuming and operationdifficulty appear difference.The way of rectum and vaginal relatively easy operation,time-consuming shortest;The way of stomach operation difficulty,time-consuminglongest.Postoperative laparotomy observation not found visceral injury around the road.Ittook about10minutes established pneumoperitoneum,can meet meet the need to explorationvision.The way of stomach make well exploration in lower abdominal viscera such asbladder, ovarian,oviduct.Overturn lens can observed part of the liver,gallbladder,spleen,stomach,and the diaphragmatic.The way of bowel and transvaginal observation almostunanimously range.Observation results are ideal in upper abdominal viscera as to the liver,gallbladder and spleen, stomach, the diaphragmatic,but detection of liver diaphragmatic faceoperation seem difficult.For lower abdominal viscera need to overturn lens, detection onlypart of the bladder, ovarian, fallopian tube.All of the road can not exploration retroperitonealorgans such as kidney, pancreas, ureteral.For large large intestine, small intestine, omental,the parietal peritoneum no obvious difference,all visible.All organs can perform targetedbiopsy successfully, but the same viscera in different approaches biopsy appera differentdifficulty.Conclusion：NOTES in the abdominal exploration and targeted biopsy have show itsbig advantages and potential,different way into abdomen can make different observationrange,we should select suitable way according to purpose viscera.