Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases

Abstract

Until specifically designed endoscopic tools are available for NOTES, the hybrid technique with US dissection conducted through a 5-mm port should be preferred in transvaginal cholecystectomy in order to shorten the duration of surgery and make this approach effective, safe and reproducible. After a mean follow-up of 1 year, none of our patients has complained of any problem related to transvaginal approach.

Transvaginal-hybrid vs. single-port-access vs. ‘conventional’ laparoscopic cholecystectomy: a prospective observational study

“…Results of the observational study presented here show no difference in operative time among the evaluated procedures and are in accordance with other published data [4,9,12,15,16]. Some authors even reported significantly longer operative times with the new procedures [2,7,10,11,14,17].…”

“…More than 150 publications in the last 5 years have dealt with transvaginal cholecystectomy, mainly performed as part of a hybrid technique (namely, with an additional route of transabdominal laparoscopic access) as well as with single-incision cholecystectomies [1,3,4,[9][10][11][12][13][14][15][16][17][18].…”

“…The first prospective randomised study of single-port cholecystectomy in 40 patients was published this year, but it was only double armed [17]. Most of the published data are feasibility studies, retrospective data analyses, 'how we do it' manuscripts or limited two-armed prospective data collections [1,3,4,7,9,10,[12][13][14][15][16][18][19][20]. Up to now, no prospective three-armed study comparing 'conventional' laparoscopic, single-incision and transvaginal cholecystectomy has been published.…”

Transvaginal Natural Orifice Transluminal Endoscopic Surgery (Notes): Surgical Technique and Results

“…Since then, this access has been used to perform several procedures, including nephrectomy (Branco et al, 2008b;Castillo et al, 2009;Kaouk et al, 2010;Ribal Caparrós et al, 2009), tubal sterilization (Kondo et al, 2009), liver resection (Noguera et al, 2008), sleeve gastrectomy (Fischer et al, 2009;Ramos et al, 2008b), adjustable gastric banding (Michalik et al, 2010), incisional hernia repair (Jacobsen et al, 2010), cancer diagnostic staging (Zorrón et al, 2008), splenectomy (Targarona et al, 2009), retroperitoneoscopy (Zorron et al, 2010a) among others. More recently, some case series have been published (Alcaraz et al, 2010;Asakuma et al, 2009;Cuadrado-Garcia et al, 2011;Hackethal et al, 2010;Horgan et al, 2009;Lehmann et al, 2010;Niu et al, 2010;Noguera et al, 2009;Noguera et al, 2010;Palanivelu et al, 2008;Pugliese et al, 2010;Ramos et al, 2008a;Sotelo et al, 2010;Zornig et al, 2010a;Zornig et al, 2010b;Zorron et al, 2010b). In China (Niu et al, 2010), cholecystectomies were successfully performed via laparoscopic assisted endoscopic transvaginal s u r g e r y .…”

Single-Incision Laparoscopic Surgery (SILS) in Biliary and Pancreatic Diseases

“…Until specifically designed endoscopic tools are available for NOTES, the hybrid technique with ultrasonic dissection conducted through a 5-mm port is being tried in natural orifice cholecystectomy in order to shorten the duration of surgery and make this approach effective, safe, and reproducible [35]. The procedure is performed by using a combination of working tools inserted through the entry port for the minilaparoscopy and the video gastroscope, inserted into peritoneal cavity by transvaginal/transgastric approach.…”