Natural orifice translumenal endoscopic surgery (NOTES) has offered significant advantages of less pain, reduced recovery time, and minimized scar after operation, demonstrating a promising development prospect. However, the large-size specimen extraction remains challenging for NOTES, due to the narrow space of the human natural orifices. To address such difficulties, a specimen extraction method that utilizes the braided fiber tube (BFT) structure with excellent retractility to accommodate and bind the bulky specimen has been proposed. Based on the theory of helical spring, the geometric model and the mechanical model of the BFT are established, and experiments have been performed to verify the accuracy of the derived mechanical model. In addition, a tensile test of using the BFT to extract large specimens via a small channel is carried out, which verifies the stable extraction performance of the proposed design. The BFT will not be damaged when extracting the specimen with a diameter less than 1.75 times of the channel diameter. A NOTES-specific specimen extraction instrument is designed according to the characteristics of NOTES, and it has three degrees-of-freedom and is able to actively capture different specimen by using a suction cup. Finally, specimen extraction experiments on NOTES multitasking platform phantom have been conducted using the prototyped instrument to validate its feasibility and effectiveness.

References

References
1.
Pearl
,
J. P.
, and
Ponsky
,
J. L.
,
2008
, “
Natural Orifice Translumenal Endoscopic Surgery: A Critical Review
,”
J. Gastrointest. Surg.
,
12
(
7
), pp.
1293
1300
.
2.
Sg
,
D. L. F.
,
Demaria
,
E. J.
,
Reynolds
,
J. D.
,
Portenier
,
D. D.
, and
Pryor
,
A. D.
,
2007
, “
New Developments in Surgery: Natural Orifice Transluminal Endoscopic Surgery (NOTES)
,”
Arch. Surg.
,
142
(
3
), pp.
295
297
.
3.
Nesargikar
,
P. N.
, and
Jaunoo
,
S. S.
,
2009
, “
Natural Orifice Translumenal Endoscopic Surgery (NOTES)
,”
Int. J. Surg.
,
7
(
3
), pp.
232
236
.
4.
Rattner
,
D.
, and
Kalloo
,
A.
,
2006
, “
ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery
,”
Surg. Endoscopy Other Interventional Tech.
,
20
(
2
), pp.
329
333
.
5.
Lima
,
E.
,
Rolanda
,
C.
,
Pego
,
J. M.
,
Henriques-Coelho
,
T.
,
Silva
,
D.
,
Carvalho
,
J. L.
, and
Correia-Pinto
,
J.
,
2006
, “
Transvesical Endoscopic Peritoneoscopy: A Novel 5 Mm Port for Intra-Abdominal Scarless Surgery
,”
J. Urol.
,
176
(
2
), pp.
802
805
.
6.
Mcgee
,
M. F.
,
Rosen
,
M. J.
,
Marks
,
J.
,
Onders
,
R. P.
,
Chak
,
A.
,
Faulx
,
A.
,
Chen
,
V. K.
, and
Ponsky
,
J.
,
2006
, “
A Primer on Natural Orifice Translumenal Endoscopic Surgery: Building a New Paradigm
,”
Surg. Innovation
,
13
(
2
), pp.
86
93
.
7.
Zuo
,
S. Y.
, and
Wang
,
S. X.
,
2016
, “
Current and Emerging Robotic Assisted Intervention for NOTES
,”
Expert Rev. Med. Devices
,
13
(
12
), pp.
1095
1105
.
8.
Daher
,
R.
,
Chouillard
,
E.
, and
Panis
,
Y.
,
2014
, “
New Trends in Colorectal Surgery: Single Port and Natural Orifice Techniques
,”
World J. Gastroenterol.
,
20
(
48
), pp.
18104
18120
.
9.
Santos
,
B. F.
, and
Hungness
,
E. S.
,
2011
, “
Natural Orifice Translumenal Endoscopic Surgery: Progress in Humans Since White Paper
,”
World J. Gastroenterol.
,
17
(
13
), pp.
1655
1665
.
10.
Sumer
,
F.
,
Kayaalp
,
C.
,
Polat
,
Y.
,
Ertugrul
,
I.
, and
Karagul
,
S.
,
2016
, “
Transgastric Removal of a Polycystic Liver Disease Using Mini-Laparoscopic Excision
,”
Interventional Med. Appl. Sci.
,
8
(
2
), pp.
89
92
.
11.
Wei
,
D.
,
Han
,
Y.
,
Li
,
M.
,
Wang
,
Y.
,
Chen
,
Y.
,
Luo
,
Y.
, and
Jiang
,
Y. G.
,
2016
, “
Pure Retroperitoneal Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Nephrectomy Using Standard Laparoscopic Instruments: A Safety and Feasibility Study in a Porcine Model
,”
BMC Urol.
,
16
(
1
), pp.
1
6
.
12.
Firaza
,
P. N.
,
Lorenzo
,
E. I.
,
Rd
,
B. J.
,
Reyes
,
E. L.
, and
Patron
,
N. A.
,
2016
, “
Hybrid Natural Orifice Translumenal Endoscopic Surgery Transvaginal Nephrectomy in a Low-Resource Setting
,”
J. Laparoendosc. Adv. Surg. Tech. A
,
26
(
2
), pp.
99
102
.
13.
Schellpfeffer
,
M. A.
,
2011
, “
A Novel Laparoscopic Tissue Retrieval Device
,”
J. Soc. Laparoendosc. Surg.
,
15
(
4
), pp.
527
532
.
14.
Smorgick
,
N.
,
2014
, “
Laparoscopic Specimen Retrieval Bags
,”
J. Obstet. Gynecol. India
,
64
(
5
), pp.
370
372
.
15.
Isakov
,
A.
,
Murdaugh
,
K. M.
,
Burke
,
W. C.
,
Zimmerman
,
S.
,
Roche
,
E.
,
Holland
,
D.
,
Einarsson
,
J. I.
, and
Walsh
,
C. J.
,
2014
, “
A New Laparoscopic Morcellator Using an Actuated Wire Mesh and Bag
,”
ASME J. Med. Devices
,
8
(
1
), pp.
1113
1121
.
16.
Singh
,
M.
, and
Rastogi
,
A.
,
2013
, “
Endoloop-Assisted Polypectomy Technique
,”
Video J. Encycl. GI Endoscopy
,
1
(
2
), pp.
323
324
.
17.
Rengen
,
M. R.
, and
Adler
,
D. G.
,
2006
, “
Detachable Snares (Endoloop)
,”
Tech. Gastrointest. Endoscopy
,
8
(
1
), pp.
12
15
.
18.
Palanivelu
,
C.
,
Rajan
,
P. S.
,
Rangarajan
,
M.
,
Parthasarathi
,
R.
,
Senthilnathan
,
P.
, and
Prasad
,
M.
,
2008
, “
Transvaginal Endoscopic Appendectomy in Humans: A Unique Approach to NOTES—World's First Report
,”
Surg. Endoscopy
,
22
(
5
), pp.
1343
1347
.
19.
Zorron
,
R.
,
Filgueiras
,
M.
,
Maggioni
,
L. C.
,
Pombo
,
L.
,
Lopes
,
C. G.
, and
Lacerda
,
O. A.
,
2007
, “
NOTES. Transvaginal Cholecystectomy: Report of the First Case
,”
Surg. Innovation
,
14
(
4
), pp.
279
283
.
20.
Decarli
,
L.
,
Zorron
,
R.
,
Branco
,
A.
,
Lima
,
F. C.
,
Tang
,
M.
,
Pioneer
,
S. R.
,
Zahin
,
I.
, Jr
,
Schulte
,
A. A.
,
Bigolin
,
A. V.
, and
Gagner
,
M.
,
2008
, “
Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Cholecystectomy in a Morbidly Obese Patient
,”
Obesity Surg.
,
18
(
7
), pp.
886
889
.
21.
Hu
,
J.
,
2008
,
3-D Fibrous Assemblies: Properties, Applications and Modelling of Three-Dimensional Textile Structures
,
CRC Press/Woodhead Publishing
, Boca Raton, FL.
22.
Ma
,
D.
,
Dargush
,
G. F.
,
Natarajan
,
S. K.
,
Levy
,
E. I.
,
Siddiqui
,
A. H.
, and
Meng
,
H.
,
2012
, “
Computer Modeling of Deployment and Mechanical Expansion of Neurovascular Flow Diverter in Patient-Specific Intracranial Aneurysms
,”
J. Biomech.
,
45
(
13
), pp.
2256
2263
.
23.
Bouillot
,
P.
,
Brina
,
O.
,
Ouared
,
R.
,
Yilmaz
,
H.
,
Farhat
,
M.
,
Erceg
,
G.
,
Lovblad
,
K. O.
,
Vargas
,
M. I.
,
Kulcsar
,
Z.
, and
Pereira
,
V. M.
,
2016
, “
Geometrical Deployment for Braided Stent
,”
Med. Image Anal.
,
30
, pp.
85
94
.
24.
Jedwab
,
M. R.
, and
Clerc
,
C. O.
,
1993
, “
A Study of the Geometrical and Mechanical Properties of a Self-Expanding Metallic Stent—Theory and Experiment
,”
J. Appl. Biomater.
,
4
(
1
), pp.
77
85
.
25.
Garbey
,
M.
,
Salmon
,
R.
,
Fikfak
,
V.
, and
Clerc
,
C. O.
,
2016
, “
Esophageal Stent Migration: Testing Few Hypothesis With a Simplified Mathematical Model
,”
Comput. Biol. Med.
,
79
, pp.
259
265
.
26.
De
,
B. M.
,
Van
,
C. S.
,
Mortier
,
P.
,
Van
,
L. D.
,
Van
,
I. R.
,
Verdonck
,
P.
, and
Verhegghe
,
B.
,
2009
, “
Virtual Optimization of Self-Expandable Braided Wire Stents
,”
Med. Eng. Phys.
,
31
(
4
), pp.
448
453
.
27.
Stipa
,
F.
,
Burza
,
A.
,
Curinga
,
R.
,
Santini
,
E.
,
Delle
,
S. P.
,
Avantifiori
,
R.
, and
Picchio
,
M.
,
2015
, “
Laparoscopic Colon and Rectal Resections With Intracorporeal Anastomosis and Transvaginal Specimen Extraction for Colorectal Cancer. A Case Series and Systematic Literature Review
,”
Int. J. Colorectal Dis.
,
30
(
7
), pp.
955
962
.
28.
Diana
,
M.
,
Perretta
,
S.
,
Wall
,
J.
,
Costantino
,
F. A.
,
Leroy
,
J.
,
Demartines
,
N.
, and
Marescaux
,
J.
,
2011
, “
Transvaginal Specimen Extraction in Colorectal Surgery: Current State of the Art
,”
Colorectal Dis.
,
13
(
6
), pp.
104
111
.
29.
Leung
,
A. L. H.
,
Cheung
,
H. Y. S.
, and
Li
,
M. K. W.
,
2014
, “
Advances in Laparoscopic Colorectal Surgery: A Review on NOTES and Transanal Extraction of Specimen
,”
Asian J. Endoscopic Surg.
,
7
(
1
), pp.
11
16
.
30.
Han
,
F. H.
,
Hua
,
L. X.
,
Zhao
,
Z.
,
Wu
,
J. H.
, and
Zhan
,
W. H.
,
2013
, “
Transanal Natural Orifice Specimen Extraction for Laparoscopic Anterior Resection in Rectal Cancer
,”
World J. Gastroenterol.
,
19
(
43
), pp.
7751
7757
.
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