| SYNOPSIS | 第12-14页 |
| 中文摘要 | 第14-19页 |
| abstract | 第19-23页 |
| List of Abbreviations | 第24-26页 |
| CHAPTER ONE:Introduction | 第26-44页 |
| 1.2 Aim of study | 第26-27页 |
| 1.3 Materials and Methods | 第27-34页 |
| 1.3.1 preoperative care | 第28-30页 |
| 1.3.2 operative techniques | 第30-32页 |
| 1.3.3 Clinical cholecystectomy | 第32-33页 |
| 1.3.4 Clinical Appendectomy | 第33-34页 |
| 1.3.5 Statistical analysis for Clinical Cholecystectomy and Appendectomy | 第34页 |
| 1.4 Results | 第34-37页 |
| 1.5 Discussion | 第37-43页 |
| 1.6 Conclusion | 第43-44页 |
| CHAPTER TWO:Literature review | 第44-63页 |
| 2.1 History of NOTES | 第45-59页 |
| 2.1.1 History and development of endoscopy | 第45-46页 |
| 2.1.2 History and development of minimally invasive surgery | 第46-47页 |
| 2.1.3 Approach towards NOTES | 第47-48页 |
| 2.1.3.1 Translumenal Endoscopic Techniques | 第47-48页 |
| 2.1.3.2 Fertiloscopy | 第48页 |
| 2.1.4 The initial concept of NOTES | 第48-49页 |
| 2.1.4.1 Emergence of NOTES application | 第49页 |
| 2.1.5 Successful growth of NOTES | 第49-54页 |
| 2.1.5.1 NOTES societies | 第49-54页 |
| 2.1.6 Clinical application of NOTES | 第54-57页 |
| 2.1.6.1 Decline in transgastric NOTES application | 第54-56页 |
| 2.1.6.2 Transvaginal NOTES techniques breakthrough | 第56-57页 |
| 2.1.7 Progeny of NOTES | 第57-59页 |
| 2.2 | 第59-63页 |
| 2.2.1 Endoscopic NOTES platform | 第59-60页 |
| 2.2.2 NOTES Closure,hemostatic anastomotic,and suturing devices | 第60-61页 |
| 2.2.3 Physiological mechanism of NOTES | 第61页 |
| 2.2.4 Infection prevention | 第61-63页 |
| CHAPTER THREE:PRESENT CLINICAL APPLICATIONS OF NOTES AND THE TECHNIQUES | 第63-107页 |
| 3.1 Application of NOTES in peritoneoscopy | 第64-65页 |
| 3.1.1 Human experience | 第64页 |
| 3.1.2 NOTES Future in peritoneoscopy | 第64-65页 |
| 3.2 Cholecystectomy through NOTES technique | 第65-73页 |
| 3.2.1 Transgastric cholecystectomy | 第65-68页 |
| 3.2.1.1 Techniques | 第65-67页 |
| 3.2.1.2 Results | 第67-68页 |
| 3.2.2 Transvaginal cholecystectomy | 第68-73页 |
| 3.2.2.1 Pure NOTES technique | 第68页 |
| 3.2.2.2 Hybrid technique with a flexible endoscope | 第68-69页 |
| 3.2.2.3 Hybrid technique with rigid laparoscopic instruments | 第69-71页 |
| 3.2.2.4 Discussion | 第71-72页 |
| 3.2.2.5 Conclusions | 第72-73页 |
| 3.3 Appendectomy through NOTES technique | 第73-82页 |
| 3.3.0 Different NOTES access routes for appendec<:omy | 第73页 |
| 3.3.1 Transvaginal appendectomy | 第73-76页 |
| 3.3.1.1 Pure NOTES appendectomy | 第74-75页 |
| 3.3.1.2 Hybrid NOTES appendectomy with flexibie endoscope assisted by rigid instruments | 第75页 |
| 3.3.1.3 Rigid transvaginal appendectomy assisted by flexble instruments | 第75-76页 |
| 3.3.1.4 Rigid transvaginal appendectomy | 第76页 |
| 3.3.2 Transgastric appendectomy | 第76-82页 |
| 3.3.2.1 Transgastric appendectomy through pure NOTES | 第76-77页 |
| 3.3.2.2 Transgastric appendectomy through hyb rid NOTES | 第77-80页 |
| 3.3.2.3 Single-incision appendectomy | 第80-82页 |
| 3.4 NOTES Thyroidectomy | 第82-85页 |
| 3.4.1 Clinical application of transoral surgery | 第83-85页 |
| 3.5 NOTES applications in Gynecology | 第85-92页 |
| 3.5.1 Initial historical and gynecologic appendectomies | 第85-86页 |
| 3.5.2 NOTES techniques for gynecology | 第86-88页 |
| 3.5.2.0 Transvaginal routes | 第86页 |
| 3.5.2.1 Standard colpotomy | 第86页 |
| 3.5.2.2 Endoscopic approach | 第86-88页 |
| 3.5.3 Safe and simplified NOTES methods | 第88-89页 |
| 3.5.4 Other routes for gynecologic NOTES | 第89页 |
| 3.5.5 Curent avalable gynecologic NOTES techniques | 第89-90页 |
| 3.5.6 The future application of NOTES in gynecology | 第90-92页 |
| 3.6 NOTES Applications in Colorectal Surgery | 第92-96页 |
| 3.6.1 Transcolonic route--best translumenal access for colorectal NOTES | 第92页 |
| 3.6.2 Endoscopic platforms available for colorectal NOTES techniques | 第92-93页 |
| 3.6.3 Closure of the transrectal incision | 第93页 |
| 3.6.4 Natural orifices specimen extraction(NOSE) | 第93-95页 |
| 3.6.4.1 The risk of peritoneal cavity contamination during colorectal NOSE | 第94-95页 |
| 3.6.4.2 Dysfunction of the anal sphincter | 第95页 |
| 3.6.4.3 Application of NOSE in oncology | 第95页 |
| 3.6.5 Resection of colon by hybrid NOTES techniques | 第95-96页 |
| 3.7 Bariatric NOTES Procedures | 第96-102页 |
| 3.7.1 The obstacles present for Bariatric NOTES procedures | 第96-97页 |
| 3.7.2 Laparo-endoscopic single site surgery associated to bariatric NOTES | 第97-98页 |
| 3.7.3 Technical concerns for NOTES in bariatric surgery | 第98页 |
| 3.7.3.1 Suitable translumenal access | 第98页 |
| 3.7.4 Investigation of NOTES techniques for current bariatric surger | 第98-102页 |
| 3.8 Applications of NOTES in Urologic Surgery | 第102-107页 |
| 3.8.1 Access techniques and instrumentation | 第102-105页 |
| 3.8.1.1 Preclinical-experience | 第103-104页 |
| 3.8.1.2 Clinical-experience | 第104-105页 |
| 3.8.2 Development in LESS/NOTES techniques | 第105-106页 |
| 3.8.3 conclusions | 第106-107页 |
| CHAPTER FOUR:Perspective of NOTES | 第107-118页 |
| 4.1 Evolving NOTES applications | 第107-108页 |
| 4.2 Application of NOTES in Neck surgery | 第108-109页 |
| 4.2.1 Minimally invasive techniques in neck surgery | 第108-109页 |
| 4.2.1.1 Endoscopic neck surgery through a single transaxillary incision | 第108-109页 |
| 4.2.1.2 Transoral video-assisted thyroidectomy(TOVAT) | 第109页 |
| 4.3 | 第109-111页 |
| 4.3.1 Using single-port devices in Transrectal NOTES | 第109-111页 |
| 4.3.1.1 Surgical procedures | 第110-111页 |
| 4.3.2 Future hopes of transanal NOTES | 第111页 |
| 4.4 NOTES for Retroperitoneal Access | 第111-112页 |
| 4.5 POEM | 第112-114页 |
| 4.5.1 Treatment of esophageal achalasia by Per-oral endoscopic myotomy | 第112-113页 |
| 4.5.1.1 Indications of POEM technique | 第112-113页 |
| 4.5.1.2 Procedures of POEM | 第113页 |
| 4.5.3 Prospective of the developing applications | 第113-114页 |
| 4.6 Applications of NOTES during Pregnancy | 第114-116页 |
| 4.7 Application of NOTES in Thoracic Surgery | 第116-118页 |
| 4.7.1 Introduction | 第116页 |
| 4.7.2 The future application of NOTES techniques in thoracic surgery | 第116-117页 |
| 4.7.3 Conclusion | 第117-118页 |
| Appendix | 第118-132页 |
| References | 第132-157页 |
| Publications | 第157-173页 |
| Acknowledgement | 第173-174页 |
| 学位论文评阅及答辩情况表 | 第174页 |
