Laparoscopic sleeve gastrectomy with NOTES visualization--a step toward NOTES procedures.

Background: To demonstrate that bariatric procedures can be done with natural orifice visualization (NOTES) at 2 institutions (Nucleo Universitario de Estudos de Notes Centro de Cirurgia Experimental Vila do Conde-Junqueira, Vila do Conde, Portugal and Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, RS, Brasil). NOTES is a new surgical approach that is being developed. It consists of the use of a minimally invasive technique in which the surgical procedure is performed through natural orifices, thereby circumventing incisions through the skin.
Methods: We performed vertical gastrectomy or laparoscopic sleeve gastrectomy in a porcine model using vaginal route visualization.
Results: A laparoscopic vertical sleeve gastrectomy with NOTES visualization in a porcine model was performed with safety.
Conclusion: Bariatric procedures can be done with NOTES with results as good as those using laparoscopic techniques.