Natural orifice transluminal endoscopic wedge hepatic resection with a water-jet hybrid knife in a non-survival porcine model

Figure 2 Hydro-dissection of liver segment in natural orifice transluminal endoscopic surgery procedure. Hepatic parenchyma dissection was performed using the water-jet hybrid knife kept away from the tissue in a no-touch fashion and perpendicular to but not tangentially against the predetermined surface, keeping in a smooth, reproducible, back-and-forth waving motion. A 4-mm transparent distance soft cap was mounted onto the tip of the endoscope for holding up the desired surface, subsequently avoiding the deviation in the direction of the water-jet.