| Objective:Natural orifice transluminal endoscopic surgery can eliminate surface incision, and reduce the complications and discomfort, considered to be the future direction of development of minimally invasive surgery. To evaluate the feasibility and safety of transesophageal endoscopic thoracoscopy, damage of stellate ganglion and pleural biopsy in swine model.Method:This feasibility study was conducted on the porcine model (Big White Pig).A total of four cases (including two acute and two2-week survivals). Right thoracoscopy and damage of stellate ganglion were performed in the acute cases, followed with euthanized after completion of the operating procedure. The survival cases underwent right thoracoscopy and pleural biopsy, and were kept alive for2weeks and then killed. Necropsy was then performed.Result:The animal experiment was successfully performed in3of4swine. The thoracoscopy and pleural biopsy were both identified accurately. A case in the acute experiments was dead because of arrhythmia caused by holding the stellate. Aitanium clip walk occured in one case of the survival experiment during the postoperative follow, resulting in the abscess formation within the esophageal mucosa tunnel, mediastinum and right pleural ganglion. The injury of surrounding organs, vascular injury, severe bleeding, severe mediastinal emphysema, pneumothorax and other serious conditions didn’t occur during the surgery.Conclusion:1It is safe and feasible to form the esophageal tunnel in the right rear section of the lower esophagus2It is feasible to finish the thoracoscopy in right chest and pleural biopsy by transesophageal NOTES.3Carbon dioxide pump can reduce the impact of mediastinal or intrathoracic pressure on the heart and lung function, reducing the incidence of postoperative pneumothorax.4Esophageal incision can be safely closed by the submucosal tunneling technique, but it is still necessary for the effective mucosal incision closure and post-operative fasting. |
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