Natural orifice transluminal endoscopic surgery in urology: The Chinese experience

Objective: To describe the Chinese experience of natural orifice transluminal endoscopic surgery (NOTES) in urology. Methods: From December 2008 to May 2017, 35 animal experiments and 305 clinical surgeries of NOTES or natural orifices specimen extractions (NOSE) were performed in China. The animal...

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Main Authors: Xiaofeng Zou, Guoxi Zhang, Tianpeng Xie, Yuanhu Yuan, Rihai Xiao, Gengqing Wu, Xiaoning Wang, Hui Xu, Folin Liu, Yuting Wu, Yunfeng Liao, Quanliang Liu, Yinghao Sun, Bo Yang, Linhui Wang, Chuanliang Xu, Xiaofeng Gao
Format: Article
Language:English
Published: Elsevier 2020-01-01
Series:Asian Journal of Urology
Online Access:http://www.sciencedirect.com/science/article/pii/S221438821930075X
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author Xiaofeng Zou
Guoxi Zhang
Tianpeng Xie
Yuanhu Yuan
Rihai Xiao
Gengqing Wu
Xiaoning Wang
Hui Xu
Folin Liu
Yuting Wu
Yunfeng Liao
Quanliang Liu
Yinghao Sun
Bo Yang
Linhui Wang
Chuanliang Xu
Xiaofeng Gao
author_facet Xiaofeng Zou
Guoxi Zhang
Tianpeng Xie
Yuanhu Yuan
Rihai Xiao
Gengqing Wu
Xiaoning Wang
Hui Xu
Folin Liu
Yuting Wu
Yunfeng Liao
Quanliang Liu
Yinghao Sun
Bo Yang
Linhui Wang
Chuanliang Xu
Xiaofeng Gao
author_sort Xiaofeng Zou
collection DOAJ
description Objective: To describe the Chinese experience of natural orifice transluminal endoscopic surgery (NOTES) in urology. Methods: From December 2008 to May 2017, 35 animal experiments and 305 clinical surgeries of NOTES or natural orifices specimen extractions (NOSE) were performed in China. The animal experiments included five kidney biopsies, 24 nephrectomies and six partial nephrectomies. The clinical surgeries included 12 transvaginal NOSE (TV-NOSE), 266 hybrid transvaginal NOTES (TV-NOTES) and 27 pure TV-NOTES. The TV-NOSE procedure was performed in five transumbilical laparoendoscopic single-site (U-LESS) nephrectomies, four suprapubic-assisted laparoendoscopic single-site surgery (SA-LESS) nephroureterectomies, and three laparoscopic radical cystectomies. The hybrid TV-NOTES procedure included 210 nephrectomies, 31 adrenalectomies, eight nephroureterectomies, 13 partial nephrectomies, and four heminephrectomies. The pure TV-NOTES procedure included five renal cyst decortications and 22 nephrectomies. Results: A total of 29 animal experiments were successfully performed. One partial nephrectomy was converted to standard laparoscopic surgery. Two kidney biopsies and two nephrectomies were unsuccessful. A total of 297 clinical surgeries were successfully performed. Six patients who underwent hybrid TV-NOTES were converted to open surgery. Two patients who underwent pure TV-NOTES were converted to SA-LESS. There were 22 major complications, 16 occurred intraoperatively and six postoperatively. The mean visual analog score (VAS) of 48 h after the operation was 2.5 points in TV-NOSE, 2.3 points in hybrid TV-NOTES and 1.7 points in pure TV-NOTES. The mean follow-up of 50.6 (3.0–87.0) months showed that all patients were in good condition. The umbilicus scars were nearly invisible in TV-NOSE and hybrid TV-NOTES. The vaginal incision healed well. Conclusions: TV-NOSE and TV-NOTES are feasible, safe, and effective with little injury, low pain, fast recovery, and good cosmetic outcomes in properly selected patients. They are worth consideration for urological clinical practice. Keywords: Minimally invasive surgery, Laparoscopy, Natural orifice transluminal endoscopic surgery, Transvaginal surgery, Urology, Chinese experience
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institution Kabale University
issn 2214-3882
language English
publishDate 2020-01-01
publisher Elsevier
record_format Article
series Asian Journal of Urology
spelling doaj-art-190bb189071e4141b81bc63b6cc0eaa72025-08-20T03:49:07ZengElsevierAsian Journal of Urology2214-38822020-01-01711910.1016/j.ajur.2019.07.001Natural orifice transluminal endoscopic surgery in urology: The Chinese experienceXiaofeng Zou0Guoxi Zhang1Tianpeng Xie2Yuanhu Yuan3Rihai Xiao4Gengqing Wu5Xiaoning Wang6Hui Xu7Folin Liu8Yuting Wu9Yunfeng Liao10Quanliang Liu11Yinghao Sun12Bo Yang13Linhui Wang14Chuanliang Xu15Xiaofeng Gao16Department of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, China; Corresponding author.Department of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Research Center of Jiangxi Province for Engineering Technology of Calculus Prevention and Control, Ganzhou, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Shanghai, ChinaObjective: To describe the Chinese experience of natural orifice transluminal endoscopic surgery (NOTES) in urology. Methods: From December 2008 to May 2017, 35 animal experiments and 305 clinical surgeries of NOTES or natural orifices specimen extractions (NOSE) were performed in China. The animal experiments included five kidney biopsies, 24 nephrectomies and six partial nephrectomies. The clinical surgeries included 12 transvaginal NOSE (TV-NOSE), 266 hybrid transvaginal NOTES (TV-NOTES) and 27 pure TV-NOTES. The TV-NOSE procedure was performed in five transumbilical laparoendoscopic single-site (U-LESS) nephrectomies, four suprapubic-assisted laparoendoscopic single-site surgery (SA-LESS) nephroureterectomies, and three laparoscopic radical cystectomies. The hybrid TV-NOTES procedure included 210 nephrectomies, 31 adrenalectomies, eight nephroureterectomies, 13 partial nephrectomies, and four heminephrectomies. The pure TV-NOTES procedure included five renal cyst decortications and 22 nephrectomies. Results: A total of 29 animal experiments were successfully performed. One partial nephrectomy was converted to standard laparoscopic surgery. Two kidney biopsies and two nephrectomies were unsuccessful. A total of 297 clinical surgeries were successfully performed. Six patients who underwent hybrid TV-NOTES were converted to open surgery. Two patients who underwent pure TV-NOTES were converted to SA-LESS. There were 22 major complications, 16 occurred intraoperatively and six postoperatively. The mean visual analog score (VAS) of 48 h after the operation was 2.5 points in TV-NOSE, 2.3 points in hybrid TV-NOTES and 1.7 points in pure TV-NOTES. The mean follow-up of 50.6 (3.0–87.0) months showed that all patients were in good condition. The umbilicus scars were nearly invisible in TV-NOSE and hybrid TV-NOTES. The vaginal incision healed well. Conclusions: TV-NOSE and TV-NOTES are feasible, safe, and effective with little injury, low pain, fast recovery, and good cosmetic outcomes in properly selected patients. They are worth consideration for urological clinical practice. Keywords: Minimally invasive surgery, Laparoscopy, Natural orifice transluminal endoscopic surgery, Transvaginal surgery, Urology, Chinese experiencehttp://www.sciencedirect.com/science/article/pii/S221438821930075X
spellingShingle Xiaofeng Zou
Guoxi Zhang
Tianpeng Xie
Yuanhu Yuan
Rihai Xiao
Gengqing Wu
Xiaoning Wang
Hui Xu
Folin Liu
Yuting Wu
Yunfeng Liao
Quanliang Liu
Yinghao Sun
Bo Yang
Linhui Wang
Chuanliang Xu
Xiaofeng Gao
Natural orifice transluminal endoscopic surgery in urology: The Chinese experience
Asian Journal of Urology
title Natural orifice transluminal endoscopic surgery in urology: The Chinese experience
title_full Natural orifice transluminal endoscopic surgery in urology: The Chinese experience
title_fullStr Natural orifice transluminal endoscopic surgery in urology: The Chinese experience
title_full_unstemmed Natural orifice transluminal endoscopic surgery in urology: The Chinese experience
title_short Natural orifice transluminal endoscopic surgery in urology: The Chinese experience
title_sort natural orifice transluminal endoscopic surgery in urology the chinese experience
url http://www.sciencedirect.com/science/article/pii/S221438821930075X
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