Surgical endoscopy
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The aim of the study is to describe techniques of robot-assisted parenchymal-sparing liver surgery. ⋯ Robot assistance allows optimal access to all liver segments and facilitates parenchymal-sparing surgery also for lesions located in the posterosuperior segments or in contact with main liver vessels.
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The transrectal natural orifice transluminal endoscopic surgery (NOTES) approach is a potentially promising alternative to transgastric or transvaginal approaches for intraperitoneal procedures. However, whether the optimal transrectal approach for intraperitoneal surgery is anterior or posterior remains unknown. To evaluate this, a prospective comparison of anterior and posterior transrectal NOTES approaches in a cadaveric appendectomy model was performed. ⋯ Transrectal NOTES appendectomy is feasible in a cadaveric model using an anterior transrectal approach. This approach is technically easier, results in shorter operative times, and allows for a "pure" NOTES dissection compared with a posterior transrectal approach. Leak pressure testing of NOTES closures is unreliable in the cadaveric model.