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Transintestinal hepatectomy performed by hybrid NOTES using a customized X‐TRACT Tissue Morcellator with an electrifiable round cutter
Author(s) -
Ohdaira Takeshi,
Endo Kazuhiro,
Abe Nozomi,
Yasuda Yoshikazu
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-009-0084-8
Subject(s) - hepatectomy , anatomy , computer science , engineering drawing , medicine , surgery , engineering , resection
Background/Purpose We tried to determine whether the customization of an X‐TRACT Tissue Morcellator could avoid the laceration‐induced distension of surgical incisions/openings when transintestinally removing resected liver tissue from the body, when the greatest dimension of the tissue exceeded the dimension of the opening. Methods Pigs were used to examine changes in the caliber and shape of surgical incisions made with a conventional hook knife and insulation‐tipped diathermic (IT) knife for electrodissection in endoscopy, and to examine changes in circular incision made with a customized X‐TRACT Tissue Morcellator. The ENDO CATCH II device was used to remove tissue. Results Laceration occurred in the “roundness‐lost portion” of the surgical incisions made with the hook knife, thus confirming the greatest dimension of the distended incisions and the occurrence of an irregular laceration. In the circular incision that were made with the customized X‐TRACT Tissue Morcellator, by contrast, the removal of resected liver tissue whose greatest dimension was fivefold greater than that of the surgical openings did not increase the caliber of the openings. The shape of the openings remained round, and no laceration was observed. Conclusions The use of the customized X‐TRACT Tissue Morcellator with an electrifiable round cutter allowed the performance of transintestinal hepatectomy and the removal of a solid organ through surgical openings that had been made in the gastrointestinal wall.