TY - JOUR
T1 - Endolumenal colon occlusion reduces peritoneal contamination during a transrectal NOTES procedure
T2 - a controlled porcine survival study
AU - Senft, Jonas D.
AU - Carstensen, Benedict
AU - Mischnik, Alexander
AU - Warschkow, Rene
AU - Müller-Stich, Beat P.
AU - Linke, Georg R.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background: To enable an efficient and enduring decontamination of the rectal mucosa during transanal endosocopic procedures, we developed a device for reversible endolumenal colon occlusion (ColoShield). The aim of this study was to assess the value of ColoShield in reducing peritoneal contamination during a transrectal procedure. Methods: Sixteen pigs underwent transrectal hybrid NOTES cholecystectomy after standardized disinfective rectal washout either with endolumenal colon occlusion using ColoShield (N = 8) or without colon occlusion (N = 8). Rectal swab samples were taken before and after rectal washout and at the end of the procedure. Peritoneal biopsies for microbiological evaluation were obtained at the end of the procedure and at necropsy 7 days after surgery. Results: Peritoneal contamination at the end of surgery was significantly lower using ColoShield compared to not using colon occlusion [13 (1/8) vs. 75 % (6/8); P = 0.012]. No significant differences were found regarding contamination of rectal swabs and peritoneal contamination at necropsy. Conclusion: The application of ColoShield may increase the safety of transrectal NOTES and transanal endoscopic procedures by reducing peritoneal contamination and consecutive infectious complications.
AB - Background: To enable an efficient and enduring decontamination of the rectal mucosa during transanal endosocopic procedures, we developed a device for reversible endolumenal colon occlusion (ColoShield). The aim of this study was to assess the value of ColoShield in reducing peritoneal contamination during a transrectal procedure. Methods: Sixteen pigs underwent transrectal hybrid NOTES cholecystectomy after standardized disinfective rectal washout either with endolumenal colon occlusion using ColoShield (N = 8) or without colon occlusion (N = 8). Rectal swab samples were taken before and after rectal washout and at the end of the procedure. Peritoneal biopsies for microbiological evaluation were obtained at the end of the procedure and at necropsy 7 days after surgery. Results: Peritoneal contamination at the end of surgery was significantly lower using ColoShield compared to not using colon occlusion [13 (1/8) vs. 75 % (6/8); P = 0.012]. No significant differences were found regarding contamination of rectal swabs and peritoneal contamination at necropsy. Conclusion: The application of ColoShield may increase the safety of transrectal NOTES and transanal endoscopic procedures by reducing peritoneal contamination and consecutive infectious complications.
UR - http://www.scopus.com/inward/record.url?scp=84944936737&partnerID=8YFLogxK
U2 - 10.1007/s00464-015-4582-2
DO - 10.1007/s00464-015-4582-2
M3 - Journal articles
C2 - 26487201
AN - SCOPUS:84944936737
SN - 0930-2794
VL - 30
SP - 2946
EP - 2950
JO - Surgical Endoscopy
JF - Surgical Endoscopy
IS - 7
ER -