NOTES transvaginal cholecystectomy: preliminary clinical application

Zorrón, Ricardo; Maggioni, Luís Carlos; Pombo, Luciana; Oliveira, André Lacerda de Abreu; Carvalho, Gustavo; Filgueiras, Marcos

doi:10.1007/s00464-007-9646-5

Cited by 220 publications

(141 citation statements)

References 28 publications

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“…In all cases, except one [16], at least one transparietal access was necessary to perform the cholecystectomy [13][14][15][16]. In this regard, umbilical SPA cholecystectomy is not more invasive than NOTES because it does not involve an additional translumenal access [28,29].…”

Section: Discussionmentioning

confidence: 97%

Single Port Access Laparoscopic Cholecystectomy (with video)

et al. 2008

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Background Single port access (SPA) surgery is a rapidly evolving field due to the complexity of NOTES (natural orifice translumenal endoscopic surgery). SPA combines the cosmetic advantage of NOTES and possibility to perform surgical procedure with standard laparoscopic instruments. We report a technique of umbilical SPA cholecystectomy using standard laparoscopic instruments and complying with conventional surgical principle and technique of minimally invasive cholecystectomy. Methods Preliminary, prospective experience of SPA cholecystectomy in 11 patients (median age, 46 (range, 27-63) years) scheduled for cholecystectomy was evaluated. Diagnoses for cholecystectomy were: symptomatic gallbladder lithiasis (n = 7), previous acute cholecystitis (n = 3), and biliary pancreatitis (n = 1). Results SPA cholecystectomy was feasible in all patients (median body mass index, 24 (range, 20-34) kg/m 2 ) who were scheduled for preliminary experience using conventional laparoscopic instruments. Median operative time was 52 (range, 40-77) minutes. Intraoperative cholangiography was performed in all patients, except one, and was considered normal. No peroperative or postoperative complications were recorded. Median hospital stay was less than 24 h.Conclusions SPA cholecystectomy is feasible and seems to be safe when performed by experienced laparoscopic surgeons using standard laparoscopic instrumentation. SPA cholecystectomy may be safer than the NOTES approach at this time. It has to be determined whether this approach would benefit patients, other than cosmesis, compared with standard laparoscopic cholecystectomy.

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Section: Discussionmentioning

confidence: 97%

Single Port Access Laparoscopic Cholecystectomy (with video)

et al. 2008

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“…Due to this fact, less aggressive endoscopic treatments than laparoscopic fundoplication has no wide acceptance in the surgical community worldwide. After the birth of NOTES, followed by LESS, there were a extensive research on procedures less aggressive than lapa roscopy and with better aesthetic results (8,14) . Based on the experience of several authors with minilapa roscopy and the development of new materials (1,3,6,9,10,11,12,13,14) , we have performed 27 gastrofundoplications using mini instru ments.…”

Section: Discussionmentioning

confidence: 99%

“…Among them, the surgical laparoscopy is the gold standard treatment, since the endoscopic procedures have not yet proved effec tiveness in the long term (7) . Since 2004, after the first publication on NOTES (8,14) less invasive techniques with better cosmetic results than the already esta blished laparoscopy has emerged. In Brazil, Gus tavo Carvalho (3,4,5) shown very convincing results in respect to cosmesis using instruments 2 and 3 mm, without the need for costly new equipment, or extensive learning curves of new methods such as laparoendos copic single site surgery (LESS) or NOTES (6,11,12,13) .…”

Section: Minilaparoscopic Fundoplication Technical Adaptations and Imentioning

confidence: 99%

Minilaparoscopic fundoplication: technical adaptations and initial experience

Loureiro

Claus

Carvalho

et al. 2012

Arq. Gastroenterol.

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CONTEXT: Gastroesophageal reflux diasease (GERD) is a highly prevalent disease. Treatment is divided into lifestyle modifications, medical and surgical treatment. Surgical laparoscopy is the gold standard treatment. In the last decade, there were an extensive research on procedures, less aggressive than laparoscopy and with better esthetic results. Minilaparoscopy is "reemerging" as a safe, effective and with excellent cosmetic results in selected patients treated for gastroesophageal reflux diasease. We present a serie of 27 patients treated for GERD by minilaparoscopic laparoscopy. MATERIAL: Between October 2009July 2011 a total of 27 patients underwent fundoplication by minilaparoscopy. It is used one 10mm trocar, a telescope of 30 degrees and four 3 mm trocars at regular positions. Regular surgical steps are done with no modifications. Cardiac tape, suture needles, and eventually extracting bag, gauze, are placed and taked out through the umbilical port. With these technical adjustments, we can perform the procedure safely and effectively, similarly to standard laparoscopic technique. RESULTS: Of the 27 patients, 22 were female and 5 male. The average body mass index was 25.5 kg/m². Hiatal hernias were small (<3 cm) in 24 patients. Mean operative time was 60 minutes. In all cases the hiatoplasty was performed with simple or 'x' stiches of 2.0 Ethibond. There was no need for conversion to standard laparoscopy or open surgery. The length of hospital stay was less than or equal to 24 hours in all patients. In this series of patients there were no postoperative complications. We did not observe any complication of the surgical wound. There were no evidence of recurrence of symptoms or endoscopic changes. CONCLUSION: Hiatoplasty associated with fundoplication using minilaparoscopic instruments is safe, feasible and effective. If compared to other "new access", has a spectacular esthetic results. Can be done with only minor technical adjustments, for any experienced laparoscopic surgeon, and is perfectly adaptable to our financial reality.

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“…5 Recently, the concept of natural orifice transluminal endoscopic surgery (NOTES) has emerged; however, the NOTES concept is still research based. [6][7][8] In this paper, we report comparison of SPA-LAVH versus multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH), providing details on the operative results and complication rates as well as a detailed description of the procedure.…”

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confidence: 99%