http://comum.rcaap.pt/handle/123456789/1932 Wed, 15 May 2013 23:22:09 GMT 2013-05-15T23:22:09Z http://comum.rcaap.pt/handle/123456789/3592 Title: Natural orifice transesophageal endoscopic surgery: state of the art Authors: Moreira-Pinto, J; Ferreira, A; Rolanda, C; Correia-Pinto, J Abstract: The main goal of Natural Orifice Transluminal Endoscopic Surgery (NOTES) is performing surgery avoiding skin incisions. Theoretical advantages of NOTES include decreased postoperative pain, reduction/elimination of general anesthesia, improved cosmetic outcomes, elimination of skin incision-related complications such as wound infections and hernias, and increased overall patient satisfaction. Although various forms of port creation to accomplish thoracic NOTES procedures have been proposed, transesophageal NOTES has been shown to be the most reliable one. The evolution of endoscopic submucosal transesophageal access resulted in the development of per-oral endoscopic myotomy (POEM), which had a fast transition to clinical practice. The authors present a review of the current state of the art concerning transesophageal NOTES, looking at its potential for diagnostic and therapeutic interventions as well as the hurdles yet to be overcome. Sun, 01 Jan 2012 00:00:00 GMT http://comum.rcaap.pt/handle/123456789/3592 2012-01-01T00:00:00Z http://comum.rcaap.pt/handle/123456789/3583 Title: Síndrome de Russel-Silver Authors: Nogueiras, AM; Costeiras, MT; Moreira, HS; Antunes, AH Abstract: Russel-Silver syndrome is a pattern of malformations whose most characteristic features are intrauterine and postnatal growth retardation, a characteristic facial appearance and limb asymmetry. We report a 9-month-old male born at 37 weeks' gestation. Family history, pregnancy and delivery revealed no significant anomalies. The infant had no intrauterine growth retardation (birth weight and height ranging between the 25 th and 50 th percentile). The infant's head circumference was disproportionately large for the small facial mass. Clinical findings included a small triangular face with frontal bossing, blue sclerae, thin lips with down-turned corners, retromicrognathia, clinodactyly of the fifth finger in both hands and limb asymmetry with undergrowth of the right leg and the left arm. The patient presented postnatal growth deficiency with weight and height 5th percentile; his head circumference grew normally along the 90 th percentile. Psychomotor development was appropriate for his age (9 months) according to the Sheridan Scale. On the basis of this clinical evidence we diagnosed Russel-Silver syndrome, attributing particular relevance to the normal intrauterine growth and the crossed asymmetry of the limbs. Mon, 01 Jan 2001 00:00:00 GMT http://comum.rcaap.pt/handle/123456789/3583 2001-01-01T00:00:00Z http://comum.rcaap.pt/handle/123456789/3582 Title: Mini-laparoscopy, laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery-assisted laparoscopy: novice surgeons' performance and perception in a porcine nephrectomy model Authors: Autorino, R; Kim, FJ; Rassweiler, J; Sio, M; Ribal, MJ; Liatsikos, E; Damiano, R; Cindolo, L; Bove, P; Schips, L; Rané, A; Quattrone, C; Correia-Pinto, J; Lima, E Sun, 01 Jan 2012 00:00:00 GMT http://comum.rcaap.pt/handle/123456789/3582 2012-01-01T00:00:00Z http://comum.rcaap.pt/handle/123456789/2818 Title: Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery Authors: Lima, E; Henriques-Coelho, T; Rolanda, C; Pego, JM; Silva, D; Carvalho, JL; Correia-Pinto, J Abstract: Background Recently there has been an increasing enthusiasm for using natural orifices translumenal endoscopic surgery (NOTES) to perform scarless abdominal procedures. We have previously reported the feasibility and safety of the transvesical endoscopic peritoneoscopy in a long-term survival porcine model as useful for those purposes. Herein, we report our successful experience performing transvesical and transdiaphragmatic endoscopic approach to the thoracic cavity in a long-term survival study in a porcine model. Methods Transvesical and transdiaphragmatic endoscopic thoracoscopy was performed in six anesthetized female pigs. A 5 mm transvesical port was created on the bladder wall and an ureteroscope was advanced into the peritoneal cavity. After diaphragm inspection, we introduced through the left diaphragmatic dome a ureteroscope into the left thoracic cavity. In all animals, we performed thoracoscopy as well as peripheral lung biopsy. Animals were sacrificed by day 15 postoperatively. Results We easily introduced a 9.8 Fr ureteroscope into the thoracic cavity that allowed us to visualize the pleural cavity and to perform simple surgical procedures such as lung biopsies without complications. There were neither respiratory distress episodes nor surgical complications to report. Postmortem examination revealed complete healing of vesical and diaphragmatic holes, whereas no signs of infection or adhesions were observed in the peritoneal or thoracic cavities. Conclusion This study demonstrates the feasibility of transvesical thoracoscopy in porcine model. However, although this study extends the potential applications of NOTES to the thoracic cavity, new instruments and further work are needed to provide evidence that this could be translated to humans and with advantages for patients. Mon, 01 Jan 2007 00:00:00 GMT http://comum.rcaap.pt/handle/123456789/2818 2007-01-01T00:00:00Z