Title: Animal Study of Adhesiolysis via Transumbilical Endoscopic Surgery with Gastric
Endoscopy: An Exploration
Version: 0 Date: 12 May 2025
Reviewer's report:
The authors proposed a new method for adhesiolysis with endoscopy in animals. It is interesting,
but many points need to be clarified. After reading this manuscript, as a surgeon and advanced
endoscopist, I still like laparoscopic surgery more than E-NOTES (which should not be called
NOTES because it requires an umbilical incision). My comments are as follows.
Adhesiolysis with a gastroscope will be very difficult because it’s like doing surgery with one
hand. I wish to know how the endoscopist finds the adhesion with only a gastroscope, which
has limited vision and is surrounded by dilated bowel.
-What is the expertise level of the endoscopists in this research?
Can we call it NOTES with an umbilical incision? NOTES should have no visible incision.
-What are the differences between single-port lap and this method? From my point of view,
single-port laparoscopy will be easier than the method you proposed with a similar incision
burden. In addition, the injured bowel could be repaired in case of full-thickness bowel burn
from cauterization.
-Without traction-countertraction, the proposed method sounded dangerous because
cauterization alone without traction could make a full-thickness bowel injury, which needed to
be repaired. At this time, bowel suturing may be impossible and make no sense.
-Did the authors perform water injection before cauterization? In the discussion part, they
mentioned that they inject, but the figure didn’t show this part.
-Only 3 of 8 beagles had vomiting. Could you confirm that all beagles had clinical gut
obstruction? I believe an abdominal radiograph may be more objective in diagnosing it.
-Is this still a viable treatment option for severe bowel obstruction? It may put the patients at
risk of complications. Please comment.
Title: Animal Study of Adhesiolysis via Transumbilical Endoscopic Surgery with Gastric
Endoscopy: An Exploration
Version: 0 Date: 12 May 2025
Reviewer's report:
The authors proposed a new method for adhesiolysis with endoscopy in animals. It is interesting,
but many points need to be clarified. After reading this manuscript, as a surgeon and advanced
endoscopist, I still like laparoscopic surgery more than E-NOTES (which should not be called
NOTES because it requires an umbilical incision). My comments are as follows.
Adhesiolysis with a gastroscope will be very difficult because it’s like doing surgery with one
hand. I wish to know how the endoscopist finds the adhesion with only a gastroscope, which
has limited vision and is surrounded by dilated bowel.
-What is the expertise level of the endoscopists in this research?
Can we call it NOTES with an umbilical incision? NOTES should have no visible incision.
-What are the differences between single-port lap and this method? From my point of view,
single-port laparoscopy will be easier than the method you proposed with a similar incision
burden. In addition, the injured bowel could be repaired in case of full-thickness bowel burn
from cauterization.
-Without traction-countertraction, the proposed method sounded dangerous because
cauterization alone without traction could make a full-thickness bowel injury, which needed to
be repaired. At this time, bowel suturing may be impossible and make no sense.
-Did the authors perform water injection before cauterization? In the discussion part, they
mentioned that they inject, but the figure didn’t show this part.
-Only 3 of 8 beagles had vomiting. Could you confirm that all beagles had clinical gut
obstruction? I believe an abdominal radiograph may be more objective in diagnosing it.
-Is this still a viable treatment option for severe bowel obstruction? It may put the patients at
risk of complications. Please comment.
Please review this paper.
user
Title: Animal Study of Adhesiolysis via Transumbilical Endoscopic Surgery with Gastric
Endoscopy: An Exploration
Version: 0 Date: 12 May 2025
Reviewer's report:
The authors proposed a new method for adhesiolysis with endoscopy in animals. It is interesting,
but many points need to be clarified. After reading this manuscript, as a surgeon and advanced
endoscopist, I still like laparoscopic surgery more than E-NOTES (which should not be called
NOTES because it requires an umbilical incision). My comments are as follows.
Adhesiolysis with a gastroscope will be very difficult because it’s like doing surgery with one
hand. I wish to know how the endoscopist finds the adhesion with only a gastroscope, which
has limited vision and is surrounded by dilated bowel.
-What is the expertise level of the endoscopists in this research?
Can we call it NOTES with an umbilical incision? NOTES should have no visible incision.
-What are the differences between single-port lap and this method? From my point of view,
single-port laparoscopy will be easier than the method you proposed with a similar incision
burden. In addition, the injured bowel could be repaired in case of full-thickness bowel burn
from cauterization.
-Without traction-countertraction, the proposed method sounded dangerous because
cauterization alone without traction could make a full-thickness bowel injury, which needed to
be repaired. At this time, bowel suturing may be impossible and make no sense.
-Did the authors perform water injection before cauterization? In the discussion part, they
mentioned that they inject, but the figure didn’t show this part.
-Only 3 of 8 beagles had vomiting. Could you confirm that all beagles had clinical gut
obstruction? I believe an abdominal radiograph may be more objective in diagnosing it.
-Is this still a viable treatment option for severe bowel obstruction? It may put the patients at
risk of complications. Please comment.
assistant