Animal experimental study of transoral transgastric endoscopic surgery cholecystectomy

ZHENG Hong-liang; YANG Huan; NIE Xu-biao; PENG Xue; QIAO Qiu-jian; BAI Jian-ying

doi:10.11659/jjssx.01E025124

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Animal experimental study of transoral transgastric endoscopic surgery cholecystectomy

Basic Research | 更新时间：2025-07-23

- Animal experimental study of transoral transgastric endoscopic surgery cholecystectomy
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 7, Pages: 584-588(2025)
- 作者机构：
  
  陆军军医大学第二附属医院消化内科，重庆 400037
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E025124
  CLC： R575.6
- Received：23 January 2025，
  
  Published：25 July 2025
- 稿件说明：
移动端阅览
郑泓量,杨欢,聂绪彪等.经口经胃内镜下胆囊切除术的动物实验研究[J].局解手术学杂志,2025,34(07):584-588.

ZHENG Hong-liang,YANG Huan,NIE Xu-biao,et al.Animal experimental study of transoral transgastric endoscopic surgery cholecystectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(07):584-588.
郑泓量,杨欢,聂绪彪等.经口经胃内镜下胆囊切除术的动物实验研究[J].局解手术学杂志,2025,34(07):584-588. DOI： 10.11659/jjssx.01E025124.

ZHENG Hong-liang,YANG Huan,NIE Xu-biao,et al.Animal experimental study of transoral transgastric endoscopic surgery cholecystectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(07):584-588. DOI： 10.11659/jjssx.01E025124.

摘要

目的

探讨在小型猪体内行经口经胃自然腔道内镜手术（TG-NOTES）胆囊切除术的可行性及安全性。

方法

选取11只小型猪为实验对象，行TG-NOTES胆囊切除术，按手术术式分为A组和B组，其中A组7只小型猪内镜下不解剖胆囊三角进行胆囊切除，B组4只小型猪内镜下解剖胆囊三角后再进行胆囊切除。统计2组小型猪手术成功率、手术各阶段时间时间、并发症发生情况、胆囊切除成功率、存活率。A组选取1只小型猪、B组4只小型猪进行生存实验，存活1周后处死并解剖，观察切口愈合情况和并发症情况。

结果

实验动物手术存活率为100%，胆囊切除成功率为100%。2组小型猪手术时间、切胃入腹时间、探查胆囊时间及胆囊取出时间比较，差异均无统计学意义（

0.05）。B组小型猪结扎胆囊动脉时间长于A组，剥离胆囊时间短于A组，差异均有统计学意义（

0.05）。2组小型猪并发症事件平均数比较，差异无统计学意义（

0.05）。动物生存实验后解剖发现，切口愈合良好，未见严重并发症。

结论

本研究成功建立TG-NOTES胆囊切除术模型，并证实TG-NOTES胆囊切除术具有一定安全性和可行性。

Abstract

Objective

To investigate the feasibility and safety of transoral transgastric natural orifice transluminal endoscopic surgery （TG-NOTES） cholecystectomy in miniature pigs.

Methods

A total of 11 miniature pigs were selected as the experimental subjects and underwent TG-NOTES cholecystectomy. These pigs were divided into the Group A and Group B according to the surgical procedures. Among them， 7 miniature pigs in the Group A underwent endoscopic cholecystectomy without dissecting the gallbladder triangle， while 4 miniature pigs in the Group B underwent endoscopic cholecystectomy after dissecting the gallbladder triangle. The success rate of surgery， the time of each stage of surgery， the incidence of complications， the success rate of cholecystectomy and the survival rate of miniature pigs in the two groups were counted. One miniature pig in the Group A and 4 miniature pigs in the Group B were selected for survival experiments. After surviving for 1 week， they were killed and dissected to observe the healing of incision and incidence of complications.

Results

The surgical survival rate of experimental animals was 100%， and the success rate of cholecystectomy was 100%. There was no significant difference in the surgical time， time of cut the stomach into the abdomen， time of gallbladder exploration or time of gallbladder removal of miniature pigs between the two groups （

0.05）. The time of ligating gallbladder artery of miniature pigs in the Group B was longer than that in the Group A， and the time of isdating gallbladder was shorter than that in the Group A， with statistically significant differences （

0.05）. There was no significant difference in the average number of complications of miniature pigs between the two groups （

0.05）. The dissection of animals after survival experiments revealed that the incisions healed well without serious complications.

Conclusion

This study successfully establishes the surgical model of TG-NOTES cholecystectomy， and confirms the safety and feasibility of TG-NOTES cholecystectomy.

关键词

Keywords

references

Shang L ， Shen X ， Niu W ， et al . Update on the natural orifice transluminal endoscopic surgery for gallbladder preserving gallstones therapy：a review ［J］. Medicine（Baltimore）， 2022 ， 101 （ 46 ）： e31810 . doi： 10.1097/MD.0000000000031810 http://dx.doi.org/10.1097/MD.0000000000031810 .

Wu X ， Li X ， Xie A ， et al . Transvaginal natural orifice endoscopic surgery for hysterectomy：a prospective cohort study ［J］. BMC Womens Health ， 2024 ， 24 （ 1 ）： 631 . doi： 10.1186/s12905-024-03461-w http://dx.doi.org/10.1186/s12905-024-03461-w .

Stone R ， Carey E ， Fader AN ， et al . Enhanced recovery and surgical optimization protocol for minimally invasive gynecologic surgery：an AAGL white paper ［J］. J Minim Invasive Gynecol ， 2021 ， 28 （ 2 ）： 179 - 203 . doi： 10.1016/j.jmig.2020.08.006 http://dx.doi.org/10.1016/j.jmig.2020.08.006 .

Ullah S ， Ali FS ， Liu BR . Advancing flexible endoscopy to natural orifice transluminal endoscopic surgery ［J］. Curr Opin Gastroenterol ， 2021 ， 37 （ 5 ）： 470 - 477 . doi： 10.1097/MOG.0000000000000753 http://dx.doi.org/10.1097/MOG.0000000000000753 .

中国医师协会结直肠肿瘤专业委员会NOTES专委会 . 经自然腔道内镜手术（NOTES）专家共识［J］. 中华结直肠疾病电子杂志， 2021 ， 10 （ 4 ）： 337 - 342 . doi： 10.3877/cma.j.issn.2095-3224.2021.04.001 http://dx.doi.org/10.3877/cma.j.issn.2095-3224.2021.04.001 .

Shih S ， Kantsevoy SV ， Kalloo A ， et al . Hybrid minimally invasive surgery--a bridge between laparoscopic and translumenal surgery ［J］. Surg Endosc ， 2007 ， 21 （ 8 ）： 1450 - 1453 . doi： 10.1007/s00464-007-9329-2 http://dx.doi.org/10.1007/s00464-007-9329-2 .

Park PO ， Bergström M ， Ikeda K ， et al . Experimental studies of transgastric gallbladder surgery： cholecystectomy and cholecystogastric anastomosis （videos）［J］. Gastrointest Endosc ， 2005 ， 61 （ 4 ）： 601 - 606 . doi： 10.1016/s0016-5107（04）02774-9 http://dx.doi.org/10.1016/s0016-5107（04）02774-9 .

Marescaux J ， Dallemagne B ， Perretta S ， et al . Surgery without scars： report of transluminal cholecystectomy in a human being ［J］. Arch Surg ， 2007 ， 142 （ 9 ）： 823 - 827 . doi： 10.1001/archsurg.142.9.823 http://dx.doi.org/10.1001/archsurg.142.9.823 .

Kellerhals G ， Nef J ， Hurni Y ， et al . Transvaginal natural orifice transluminal endoscopic surgery for early-stage ovarian cancer and borderline ovarian tumors：a case series ［J］. Front Surg ， 2025 ， 12 ： 1542486 . doi： 10.3389/fsurg.2025.1542486 http://dx.doi.org/10.3389/fsurg.2025.1542486 .

Xu D ， He L ， Lin Y ， et al . Does transvaginal natural orifice transluminal endoscopic surgery affect female sexual function？：a prospective cohort study ［J］. BMC Womens Health ， 2023 ， 23 （ 1 ）： 405 . doi： 10.1186/s12905-023-02566-y http://dx.doi.org/10.1186/s12905-023-02566-y .

Zhang Y ， Mao XL ， Zhou XB ， et al . Feasibility of transgastric endoscopic gallbladder-preserving surgery for benign gallbladder diseases （with video）［J］. Surg Endosc ， 2022 ， 36 （ 4 ）： 2705 - 2711 . doi： 10.1007/s00464-021-08890-4 http://dx.doi.org/10.1007/s00464-021-08890-4 .

Trunzo JA ， Poulose BK ， McGee MF ， et al . The diagnostic efficacy of natural orifice transluminal endoscopic surgery： is there a role in the intensive care unit？［J］. Surg Endosc ， 2010 ， 24 （ 10 ）： 2485 - 2491 . doi： 10.1007/s00464-010-0990-5 http://dx.doi.org/10.1007/s00464-010-0990-5 .

李杉，吴宏博，吕辰艳，等 . 经胃自然腔道内镜手术行胆囊探查术的可行性及安全性研究［J］. 局解手术学杂志， 2020 ， 29 （ 4 ）： 257 - 261 . doi： 10.11659/jjssx.02E020094 http://dx.doi.org/10.11659/jjssx.02E020094 .

Rattner D ， Kalloo A ， ASGE/SAGES Working Group . ASGE/SAGES Working Group on natural orifice translumenal endoscopic surgery. October 2005 ［J］. Surg Endosc ， 2006 ， 20 （ 2 ）： 329 - 333 . doi： 10.1007/s00464-005-3006-0 http://dx.doi.org/10.1007/s00464-005-3006-0 .

Sclabas GM ， Swain P ， Swanstrom LL . Endoluminal methods for gastrotomy closure in natural orifice transenteric surgery （NOTES）［J］. Surg Innov ， 2006 ， 13 （ 1 ）： 23 - 30 . doi： 10.1177/15533506060 1300105 http://dx.doi.org/10.1177/155335060601300105 .

Kantsevoy SV ， Hu B ， Jagannath SB ， et al . Transgastric endoscopic splenectomy：is it possible？［J］. Surg Endosc ， 2006 ， 20 （ 3 ）： 522 - 525 . doi： 10.1007/s00464-005-0263-x http://dx.doi.org/10.1007/s00464-005-0263-x .

Donatsky AM ， Holzknecht BJ ， Arpi M ， et al . Oral chlorhexidine and microbial contamination during endoscopy： possible implications for transgastric surgery.A randomized，clinical trial ［J］. Surg Endosc ， 2013 ， 27 （ 6 ）： 1914 - 1922 . doi： 10.1007/s00464-012-2686-5 http://dx.doi.org/10.1007/s00464-012-2686-5 .

胡三元，杨庆芸，张光永，等 . 经胃及阴道内镜胆囊切除动物实验研究［J］. 腹腔镜外科杂志， 2008 ， 13 （ 6 ）： 479 - 483 . doi： 10.13499/j.cnki.fqjwkzz.2008.06.006 http://dx.doi.org/10.13499/j.cnki.fqjwkzz.2008.06.006 .

Eickhoff A ， Vetter S ， von Renteln D ， et al . Effectivity of current sterility methods for transgastric NOTES procedures： results of a randomized porcine study ［J］. Endoscopy ， 2010 ， 42 （ 9 ）： 748 - 752 . doi： 10.1055/s-0030-1255597 http://dx.doi.org/10.1055/s-0030-1255597 .

Flora ED ， Wilson TG ， Martin IJ ， et al . A review of natural orifice translumenal endoscopic surgery （NOTES） for intra-abdominal surgery： experimental models， techniques， and applicability to the clinical setting ［J］. Ann Surg ， 2008 ， 247 （ 4 ）： 583 - 602 . doi： 10.1097/SLA. 0b013e3181656ce9 http://dx.doi.org/10.1097/SLA.0b013e3181656ce9 .

Wu H ， Xue D ， Deng M ， et al . Progress，challenges，and future perspectives of robot-assisted natural orifice specimen extraction surgery for colorectal cancer：a review ［J］. BMC Surg ， 2024 ， 24 （ 1 ）： 255 . doi： 10.1186/s12893-024-02538-5 http://dx.doi.org/10.1186/s12893-024-02538-5 .

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