Infection during natural orifice transluminal endoscopic surgery: a randomized, controlled study in a live porcine model.

Background: Currently reported natural orifice transluminal endoscopic surgery (NOTES) procedures in animals have been done in heterogeneous milieus ranging from nonsterile to sterile procedures, with mixed results, including no infection in those performed in nonsterile settings.

Objective: To establish the potential frequency of infection during NOTES, comparing sterile to nonsterile approaches.

Setting: Survival experiments on sixteen 50-kg pigs.