Abstract
We have been working on the development of an endoscopic full-thickness resection (EFTR) method as the first step to establish a pure natural orifice translumenal endoscopic surgery (NOTES) as part of the Kagawa NOTES project, which is a collaborative project team involving industry, academia, and government in the fields of medicine and engineering. We introduced the EFTR technique with laparoscopic assistance as a hybrid NOTES approach for removal of endolumenal growth type gastric GISTs in 2009. In this paper, we retrospectively review the clinical outcomes of ten patients who underwent EFTR utilizing the hybrid NOTES approach. Considering our preliminary clinical experiences using the EFTR method and the hybrid NOTES approach, the development of a reliable suturing device and mechanical countertraction system is essential for the safe performance of pure endolumenal EFTR without laparoscopic support. In vivo animal experiment, we have developped non-insufflation EFTR using these devices such as suturing device and countertraction system.
