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Background: Rectal prolapse is the protrusion of one or more layers of the rectum through the anal sphincter. Some of the possible causes are tenesmus, endoparasitism and large bowel inflammation. Natural orifice transluminal endoscopic surgery (NOTES) consists of advanced techniques to gain access to body cavities through natural openings without skin incision. Different access routes may be used. However, transrectal NOTES has not been often reported. This paper reports a case of rectal prolapse after transrectal NOTES in a porcine model. Case: A healthy, female domestic swine underwent experimental peritoneoscopy through transrectal route. The animal weighed 20 kg and was approximately 90 days old. Under general anesthesia, a pneumoperitoneum was created and, after this, the rectal lining was pulled out and incised so that the endoscope could be introduced into the abdominal cavity. Subsequently, the cavity was deflated and the rectal wall was sutured under direct viewing with single-layer extramucosal sutures closed with 3-0 polyglactin 910 and simple continuous pattern in the muscular region and submucosa. There was edema of the rectal lining with a slight protrusion and was reduced manually. There was prolapse recurrence and a pursestring suture was placed around the anus. The suture ruptured about 72 h after the endoscopic procedure and self-mutilation of the perineal...(AU)

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Background: Rectal prolapse is the protrusion of one or more layers of the rectum through the anal sphincter. Some of the possible causes are tenesmus, endoparasitism and large bowel inflammation. Natural orifice transluminal endoscopic surgery (NOTES) consists of advanced techniques to gain access to body cavities through natural openings without skin incision. Different access routes may be used. However, transrectal NOTES has not been often reported. This paper reports a case of rectal prolapse after transrectal NOTES in a porcine model. Case: A healthy, female domestic swine underwent experimental peritoneoscopy through transrectal route. The animal weighed 20 kg and was approximately 90 days old. Under general anesthesia, a pneumoperitoneum was created and, after this, the rectal lining was pulled out and incised so that the endoscope could be introduced into the abdominal cavity. Subsequently, the cavity was deflated and the rectal wall was sutured under direct viewing with single-layer extramucosal sutures closed with 3-0 polyglactin 910 and simple continuous pattern in the muscular region and submucosa. There was edema of the rectal lining with a slight protrusion and was reduced manually. There was prolapse recurrence and a pursestring suture was placed around the anus. The suture ruptured about 72 h after the endoscopic procedure and self-mutilation of the perineal...

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Objetivou-se comparar a resposta inflamatória e o perfil oxidativo da técnica de ovariossalpingohisterectomia (OSH) convencional com duas técnicas de Cirurgia Endoscópica por Orifícios Naturais (NOTES). Foram utilizados 15 fêmeas, alocadas em três grupos de cinco animais. No primeiro grupo, a OSH foi realizada por celiotomia convencional, no segundo, por NOTES total e, no terceiro, por NOTES híbrida. Foram realizadas as coletas sanguíneas antes do procedimento cirúrgico (basal), 3, 6, 12, 24, 48 e 72h pós-operatórias. A atividade da catalase manteve-se alta nos três grupos estudados, entretanto a peroxidação lipídica, medida pelos níveis dos produtos de reação com o ácido tiobarbitúrico (TBARS), ocorreu mais acentuadamente no grupo convencional e foi quase que imperceptível no grupo de NOTES total. Nos três grupos estudados, ocorreu elevação na atividade da butirilcolinesterase e acetilcolinesterases, bem como aumento leucocitário neutrofílico nas primeiras horas pós-cirúrgicas. Conclui-se que a inflamação sistêmica acontece de forma similar nas três técnicas operatórias, com ressalva para as realizadas por NOTES total que mantiveram as mais baixas taxas oxidativas.(AU)

This study aimed at comparing the inflammatory response and the oxydative profile of the conventional ovarysalpingohysterectomy (OSH) technique to Totally Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Hybrid NOTES. Group of fifteen female dogs was used for each technique. Blood samples were taken before the surgical procedure (basal) and 3, 6, 12, 24, 48 and 72h postoperative. The catalase activity was increased in the three studied groups. Nevertheless, lipid peroxidation, measured by TBARS (thiobarbituric acid reactive substances) levels, was higher in the conventional group and almost indistinguishable in the total NOTES group. In the three analyzed groups, both butyrylcholinesterase and acetylcholinesterase activities were increased as well as the neutrophil counts during the first post-surgical hours. It is possible to conclude that systemic inflammation occurs in a similar way in the three operative techniques; however, total NOTES technique presents lower levels of cellular oxidative damage, particularly if compared to the conventional approach.(AU)

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Objetivou-se comparar a resposta inflamatória e o perfil oxidativo da técnica de ovariossalpingohisterectomia (OSH) convencional com duas técnicas de Cirurgia Endoscópica por Orifícios Naturais (NOTES). Foram utilizados 15 fêmeas, alocadas em três grupos de cinco animais. No primeiro grupo, a OSH foi realizada por celiotomia convencional, no segundo, por NOTES total e, no terceiro, por NOTES híbrida. Foram realizadas as coletas sanguíneas antes do procedimento cirúrgico (basal), 3, 6, 12, 24, 48 e 72h pós-operatórias. A atividade da catalase manteve-se alta nos três grupos estudados, entretanto a peroxidação lipídica, medida pelos níveis dos produtos de reação com o ácido tiobarbitúrico (TBARS), ocorreu mais acentuadamente no grupo convencional e foi quase que imperceptível no grupo de NOTES total. Nos três grupos estudados, ocorreu elevação na atividade da butirilcolinesterase e acetilcolinesterases, bem como aumento leucocitário neutrofílico nas primeiras horas pós-cirúrgicas. Conclui-se que a inflamação sistêmica acontece de forma similar nas três técnicas operatórias, com ressalva para as realizadas por NOTES total que mantiveram as mais baixas taxas oxidativas.

This study aimed at comparing the inflammatory response and the oxydative profile of the conventional ovarysalpingohysterectomy (OSH) technique to Totally Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Hybrid NOTES. Group of fifteen female dogs was used for each technique. Blood samples were taken before the surgical procedure (basal) and 3, 6, 12, 24, 48 and 72h postoperative. The catalase activity was increased in the three studied groups. Nevertheless, lipid peroxidation, measured by TBARS (thiobarbituric acid reactive substances) levels, was higher in the conventional group and almost indistinguishable in the total NOTES group. In the three analyzed groups, both butyrylcholinesterase and acetylcholinesterase activities were increased as well as the neutrophil counts during the first post-surgical hours. It is possible to conclude that systemic inflammation occurs in a similar way in the three operative techniques; however, total NOTES technique presents lower levels of cellular oxidative damage, particularly if compared to the conventional approach.

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O aprimoramento de cirurgias minimamente invasivas pode conferir resultados pós-operatórios aindamelhores, tais como melhorias na cicatrização e no aspecto estético, menor dor pós-operatória e diminuiçãodo período de internação hospitalar. A cirurgia endoscópica transluminal por orifícios naturais(Natural Orifice Transluminal Endoscopic Surgery - NOTES) em alguns casos pode ser alternativa àcirurgia laparoscópica, com a vantagem de eliminar incisões abdominais, uma vez que combina técnicaslaparoscópicas e endoscópicas para acessar o abdome através de orifícios naturais. Apesar de se tratarde acesso em desenvolvimento, muitas vantagens poderão ser atribuídas a NOTES, tais como menoresincidências de hérnias, de infecção da ferida operatória e de aderências. A cirurgia laparoendoscópicapor único portal (Laparoendoscopic Single-site Surgery- LESS) é outra modalidade atual dentro dosprocedimentos videocirúrgicos, na qual a operação é realizada por incisão cutânea única, com ou sem ouso de dispositivos ou equipamentos específicos. As indicações e contra-indicações de cada abordagemcirúrgica surgirão conforme o desenvolvimento técnico. Neste artigo, os autores abordam o histórico davideocirurgia na medicina veterinária e o estado atual das categorias de NOTES e LESS.(AU)

The improvement of minimally invasive surgery can provides better postoperative results, such as betterscar healing, improved cosmetics results, less postoperative pain and earlier discharge from hospital.Transluminal endoscopic surgery by natural orifices can be an alternative to laparoscopic surgery, withthe advantage of eliminating abdominal incisions since it combines endoscopic and laparoscopic techniquesto access the abdominal cavity via natural orifices. Despite being a technique under development,many advantages would be attributed to NOTES, such as lower incidence of hernias, surgical woundinfection and adhesion. The Laparoendoscopic Single Site Surgery (LESS) is another current techniquewithin the video surgical procedures of laparoscopic procedures, which is used a single abdominal incision,with our without specific devices and equipment. The indications and contra indications of eachapproach will arise according to the development of the surgical techniques. In this article, the authors review the history of the video surgery in veterinary medicine and the current conditions of NOTES andLESS categories.(AU)

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O aprimoramento de cirurgias minimamente invasivas pode conferir resultados pós-operatórios aindamelhores, tais como melhorias na cicatrização e no aspecto estético, menor dor pós-operatória e diminuiçãodo período de internação hospitalar. A cirurgia endoscópica transluminal por orifícios naturais(Natural Orifice Transluminal Endoscopic Surgery - NOTES) em alguns casos pode ser alternativa àcirurgia laparoscópica, com a vantagem de eliminar incisões abdominais, uma vez que combina técnicaslaparoscópicas e endoscópicas para acessar o abdome através de orifícios naturais. Apesar de se tratarde acesso em desenvolvimento, muitas vantagens poderão ser atribuídas a NOTES, tais como menoresincidências de hérnias, de infecção da ferida operatória e de aderências. A cirurgia laparoendoscópicapor único portal (Laparoendoscopic Single-site Surgery- LESS) é outra modalidade atual dentro dosprocedimentos videocirúrgicos, na qual a operação é realizada por incisão cutânea única, com ou sem ouso de dispositivos ou equipamentos específicos. As indicações e contra-indicações de cada abordagemcirúrgica surgirão conforme o desenvolvimento técnico. Neste artigo, os autores abordam o histórico davideocirurgia na medicina veterinária e o estado atual das categorias de NOTES e LESS.

The improvement of minimally invasive surgery can provides better postoperative results, such as betterscar healing, improved cosmetics results, less postoperative pain and earlier discharge from hospital.Transluminal endoscopic surgery by natural orifices can be an alternative to laparoscopic surgery, withthe advantage of eliminating abdominal incisions since it combines endoscopic and laparoscopic techniquesto access the abdominal cavity via natural orifices. Despite being a technique under development,many advantages would be attributed to NOTES, such as lower incidence of hernias, surgical woundinfection and adhesion. The Laparoendoscopic Single Site Surgery (LESS) is another current techniquewithin the video surgical procedures of laparoscopic procedures, which is used a single abdominal incision,with our without specific devices and equipment. The indications and contra indications of eachapproach will arise according to the development of the surgical techniques. In this article, the authors review the history of the video surgery in veterinary medicine and the current conditions of NOTES andLESS categories.

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