Table 1.

Randomised controlled trials of methods of infection prevention for transgastric NOTES procedures.

Study	Subject	Intervention	Control	Closure	Outcome measures	Conclusion
Ramamoorthy et al. [11]	30 rats	PPI prior to gastrotomy	Gastrotomy	Direct sutured	Serial WBC and CRP, day 14 necropsy and culture of peritoneum	Higher rate of peritoneal contamination and abscess formation with PPI
Buck et al. [16]	37 pigs	NOTES with mesh placement following gastric irrigation with saline and antibiotics	NOTES without mesh or endoscopy with PPI followed by laparoscopic mesh (both control groups with antibiotics and saline irrigation)	Jumbo clips	Day 14 necropsy, gastric aspirate cultures	36% NOTES mesh infection, significantly higher than laparoscopic mesh infection rate. No infection in NOTES-only control.
Giday et al. [14]	16 pigs	Systemic antibiotics and povidone-iodine gastric irrigation, NOTES liver biopsy or ovarian biopsy	NOTES biopsies without antibiotics or irrigation using disinfected but nonsterile equipment	T-bar devices	Day 7 necropsy and cultures	100% gross infection rate in control group, 0% in study group
McGee et al. [15]	19 pigs	High volume (6 L) saline or antibiotic gastric irrigation followed by NOTES peritoneoscopy and sterile foreign body placement	NOTES peritoneoscopy with 50 mL saline irrigation, sterile foreign body placement	PEG	Day 14 necropsy, gastric aspirate cultures	No differences in rate of abscess, positive culture or foreign body infection rate
Eickhoff et al. [13]	16 pigs	PPI, oral and IV antibiotics, chlorhexidine and antibiotic irrigation, NOTES gallbladder exploration and tubal ligation	Saline irrigation only, NOTES as in trial group	Plicator device	Day 14 necropsy and cultures, serial WBC and CRP	1/8 study group and 6/8 control positive cultures, significantly higher CFU load in control group

WBC: White blood cell count, CRP: C-reactive protein, PPI: proton pump inhibitor, PEG: percutaneous endoscopic gastrostomy, CFU: colony forming units.