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Published in: Langenbeck's Archives of Surgery 7/2013

01-10-2013 | Review Article

Innovations in minimally invasive surgery: lessons learned from translational animal models

Authors: D. Mutter, B. Dallemagne, S. Perretta, M. Vix, J. Leroy, P. Pessaux, J. Marescaux

Published in: Langenbeck's Archives of Surgery | Issue 7/2013

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Abstract

Purpose

Animal models are key elements of surgical research and promotion of new techniques. Inanimate models, anatomical specimens, and living animals are all necessary to solve the various problems encountered by the advent of a new surgical technique. The development of Natural Orifice Transluminal Endoscopic Surgery (NOTES) procedures is a representative model.

Methods

Over 400 experimental procedures were performed in inanimate models, ex vivo tissues and animals to solve all problems faced by the development of NOTES surgery: peritoneal access, gastrotomy closure, exposure, retraction, dissection as well as education to start this new procedure.

Results

The successive use of all models allows to identify the ideal solution for each problem and to precisely define the safest and most reliable option to apply the new technique in patients. It allowed to perform the first transvaginal and transgastric cholecystectomy in patients in a safe way.

Conclusion

Animal experimentation remains necessary as even sophisticated computer-based solutions are unable to model all interactions between molecules, cells, tissues, organisms, and their environment. Animal research is required in many areas to validate new technologies, develop training, let alone its major goal (namely to avoid using patients for experimentation) which is to be the first “model” for the surgeon.
Literature
1.
go back to reference Royal Society (2004) The use of non-human animals in research: a guide for scientists. The Royal Society, London, pp 1–17 Royal Society (2004) The use of non-human animals in research: a guide for scientists. The Royal Society, London, pp 1–17
2.
go back to reference Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA, Kantsevoy SV (2004) Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60:114–117PubMedCrossRef Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA, Kantsevoy SV (2004) Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60:114–117PubMedCrossRef
3.
go back to reference Sohn DK, Turner BG, Gee DW, Willingham FF, Sylla P, Cizginer S, Konuk Y, Brugge WR, Rattner DW (2010) Reducing the unexpectedly high rate of injuries caused by NOTES gastrotomy creation. Surg Endosc 24:277–282PubMedCrossRef Sohn DK, Turner BG, Gee DW, Willingham FF, Sylla P, Cizginer S, Konuk Y, Brugge WR, Rattner DW (2010) Reducing the unexpectedly high rate of injuries caused by NOTES gastrotomy creation. Surg Endosc 24:277–282PubMedCrossRef
4.
go back to reference Sumiyama K, Gostout CJ (2008) Techniques for transgastric access to the peritoneal cavity. Gastrointest Endosc Clin N Am 18:235–244PubMedCrossRef Sumiyama K, Gostout CJ (2008) Techniques for transgastric access to the peritoneal cavity. Gastrointest Endosc Clin N Am 18:235–244PubMedCrossRef
5.
go back to reference Asakuma M, Perretta S, Allemann P, Cahill R, Con SA, Solano C, Pasupathy S, Mutter D, Dallemagne B, Marescaux J (2009) Challenges and lessons learned from NOTES cholecystectomy initial experience: a stepwise approach from the laboratory to clinical application. J Hepatobiliary Pancreat Surg 16:249–54PubMedCrossRef Asakuma M, Perretta S, Allemann P, Cahill R, Con SA, Solano C, Pasupathy S, Mutter D, Dallemagne B, Marescaux J (2009) Challenges and lessons learned from NOTES cholecystectomy initial experience: a stepwise approach from the laboratory to clinical application. J Hepatobiliary Pancreat Surg 16:249–54PubMedCrossRef
6.
go back to reference Dallemagne B, Perretta S, Allemann P, Asakuma M, Marescaux J (2009) Transgastric hybrid cholecystectomy. Br J Surg 96:1162–1166PubMedCrossRef Dallemagne B, Perretta S, Allemann P, Asakuma M, Marescaux J (2009) Transgastric hybrid cholecystectomy. Br J Surg 96:1162–1166PubMedCrossRef
7.
go back to reference Ghezzi F, Raio L, Mueller MD, Gyr T, Buttarelli M, Franchi M (2002) Vaginal extraction of pelvic masses following operative laparoscopy. Surg Endosc 16:1691–6PubMedCrossRef Ghezzi F, Raio L, Mueller MD, Gyr T, Buttarelli M, Franchi M (2002) Vaginal extraction of pelvic masses following operative laparoscopy. Surg Endosc 16:1691–6PubMedCrossRef
8.
go back to reference Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–6PubMedCrossRef Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–6PubMedCrossRef
9.
go back to reference Asakuma M, Perretta S, Cahill RA, Solano C, Pasupathy S, Dallemagne B, Tanigawa N, Marescaux J (2009) Peroral dual scope for natural orifice transluminal endoscopic surgery (NOTES) gastrotomy closure. Surg Innov 16:97–103PubMedCrossRef Asakuma M, Perretta S, Cahill RA, Solano C, Pasupathy S, Dallemagne B, Tanigawa N, Marescaux J (2009) Peroral dual scope for natural orifice transluminal endoscopic surgery (NOTES) gastrotomy closure. Surg Innov 16:97–103PubMedCrossRef
10.
go back to reference Perretta S, Sereno S, Forgione A, Dallemagne B, Coumaros D, Boosfeld C, Moll C, Marescaux J (2007) A new method to close the gastrotomy by using a cardiac septal occluder: long-term survival study in a porcine model. Gastrointest Endosc 66:809–813PubMedCrossRef Perretta S, Sereno S, Forgione A, Dallemagne B, Coumaros D, Boosfeld C, Moll C, Marescaux J (2007) A new method to close the gastrotomy by using a cardiac septal occluder: long-term survival study in a porcine model. Gastrointest Endosc 66:809–813PubMedCrossRef
11.
go back to reference Arezzo A, Zornig C, Mofid H, Fuchs KH, Breithaupt W, Noguera J, Kaehler G, Magdeburg R, Perretta S, Dallemagne B, Marescaux J, Copaescu C, Graur F, Szasz A, Forgione A, Pugliese R, Buess G, Bhattacharjee HK, Navarra G, Godina M, Shishin K, Morino M (2013) The EURO-NOTES clinical registry for natural orifice transluminal endoscopic surgery: a 2-year activity report. Surg Endosc 27:3073–84PubMedCrossRef Arezzo A, Zornig C, Mofid H, Fuchs KH, Breithaupt W, Noguera J, Kaehler G, Magdeburg R, Perretta S, Dallemagne B, Marescaux J, Copaescu C, Graur F, Szasz A, Forgione A, Pugliese R, Buess G, Bhattacharjee HK, Navarra G, Godina M, Shishin K, Morino M (2013) The EURO-NOTES clinical registry for natural orifice transluminal endoscopic surgery: a 2-year activity report. Surg Endosc 27:3073–84PubMedCrossRef
12.
go back to reference Perretta S, Dallemagne B, Donatelli G, Mutter D, Marescaux J (2011) Multimedia article. The fear of transgastric cholecystectomy: misinterpretation of the biliary anatomy. Surg Endosc 25:648PubMedCrossRef Perretta S, Dallemagne B, Donatelli G, Mutter D, Marescaux J (2011) Multimedia article. The fear of transgastric cholecystectomy: misinterpretation of the biliary anatomy. Surg Endosc 25:648PubMedCrossRef
13.
go back to reference Perretta S, Dallemagne B, Coumaros D, Marescaux J (2008) Natural orifice transluminal endoscopic surgery: transgastric cholecystectomy in a survival porcine model. Surg Endosc 22:1126–1130PubMedCrossRef Perretta S, Dallemagne B, Coumaros D, Marescaux J (2008) Natural orifice transluminal endoscopic surgery: transgastric cholecystectomy in a survival porcine model. Surg Endosc 22:1126–1130PubMedCrossRef
14.
go back to reference Marescaux J, Leroy J, Gagner M, Rubino F, Mutter D, Vix M, Butner SE, Smith MK (2001) Transatlantic robot-assisted telesurgery. Nature 413:379–380PubMedCrossRef Marescaux J, Leroy J, Gagner M, Rubino F, Mutter D, Vix M, Butner SE, Smith MK (2001) Transatlantic robot-assisted telesurgery. Nature 413:379–380PubMedCrossRef
15.
go back to reference Wall J, Diana M, Leroy J, Deruijter V, Gonzales KD, Lindner V, Harrison M, Marescaux J (2013) MAGNAMOSIS IV: magnetic compression anastomosis for minimally invasive colorectal surgery. Endoscopy 45:643–8PubMedCrossRef Wall J, Diana M, Leroy J, Deruijter V, Gonzales KD, Lindner V, Harrison M, Marescaux J (2013) MAGNAMOSIS IV: magnetic compression anastomosis for minimally invasive colorectal surgery. Endoscopy 45:643–8PubMedCrossRef
16.
go back to reference Leroy J, Barry B, Melani A, Mutter D, Marescaux J (2013) No scar transanal total mesorectal excision. The last stop to pure NOTES® colorectal surgery. JAMA Surg 148:226–30PubMedCrossRef Leroy J, Barry B, Melani A, Mutter D, Marescaux J (2013) No scar transanal total mesorectal excision. The last stop to pure NOTES® colorectal surgery. JAMA Surg 148:226–30PubMedCrossRef
18.
go back to reference Mutter D, Vix M, Dallemagne B, Perretta S, Leroy J, Marescaux J (2011) WeBSurg: an innovative educational Web site in minimally invasive surgery-principles and results. Surg Innov 18:8–14PubMedCrossRef Mutter D, Vix M, Dallemagne B, Perretta S, Leroy J, Marescaux J (2011) WeBSurg: an innovative educational Web site in minimally invasive surgery-principles and results. Surg Innov 18:8–14PubMedCrossRef
Metadata
Title
Innovations in minimally invasive surgery: lessons learned from translational animal models
Authors
D. Mutter
B. Dallemagne
S. Perretta
M. Vix
J. Leroy
P. Pessaux
J. Marescaux
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 7/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-013-1115-0

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