Disinfection of the Access Orifice in NOTES: Evaluation of the Evidence Base
2011

Disinfection Methods in Natural Orifice Surgery

Sample size: 22 publication Evidence: low

Author Information

Author(s): Mikael H. Sodergren, Philip Pucher, James Clark, David R. C. James, Jenny Sockett, Nagy Matar, Julian Teare, Guang-Zhong Yang, Ara Darzi

Primary Institution: Imperial College London

Hypothesis

What are the best methods for disinfecting access orifices in natural orifice translumenal endoscopic surgery (NOTES) to prevent infections?

Conclusion

The study recommends antiseptic irrigation for transvaginal access and suggests no preoperative preparation for the transgastric approach, but calls for further human trials.

Supporting Evidence

  • Transgastric access is the most commonly investigated approach with several experimental trials published.
  • Antiseptic irrigation is recommended for transvaginal NOTES access.
  • There is currently no level 1 evidence for disinfection methods in NOTES procedures.

Takeaway

This study looks at how to keep things clean during certain types of surgeries that use natural openings in the body, and it found that washing with special solutions helps prevent infections.

Methodology

A literature review was conducted to evaluate evidence for access orifice preparation in NOTES procedures, focusing on infectious complications.

Potential Biases

The studies reviewed often used animal models, which may not fully represent human outcomes.

Limitations

The evidence base is limited and methodologically not robust, with a lack of controlled human trials.

Digital Object Identifier (DOI)

10.1155/2011/245175

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