NOTES: Transvaginal Endoscopic Cholecystectomy in Humans—Preliminary Report of a Case Series

Abstract

Since the first description of NOTES, there has been no standardized technique. In our technique, we used a single 3-mm trocar for visualizing the entry and exit of the endoscope, maintaining and measuring pneumoperitoneum, and retracting the gall bladder fundus. The instruments that were used were the conventional endoscopic ones. The transvaginal approach seems to be a viable alternative to the transgastric approach for cholecystectomy, as the transgastric approach has certain inherent problems like leakage from the gastrotomy site and poor ergonomy. The downside to the transvaginal approach is that it is possible only in women.

NOTES über den transvaginalen Zugang

“…Bernhardt und Kollegen [3]. Alle anderen transvaginalen Operationen brauchten ein oder mehrere laparoskopische Hilfsinstrumente, oder die Scheide wurde hauptsächlich als Bergeweg genutzt: Appendektomie, rechtsseitige Hemikolektomie, Sigmaresektion, Splenektomie, Leberresektion, Sleeve-Gastrektomie, atypische Magenresektion, Nephrektomie, Versorgung einer Nabelhernie[5, 9,12,16,17,19,20,24,26,28]. Dabei handelt es sich überwie-gend um Einzelfallbeschreibungen.Im Gegensatz zu den geringen Fallzahlen in publizierten Serien weist das deutsche NOTES-Register der DGAV (Deutschen Gesellschaft für Allgemeinund Viszeralchirurgie) Zahlen in ganz anderen Dimensionen auf.…”

Cirurgia por orifícios naturais transcolônica: acesso NOTES peri-retal (PNA) para excisão mesoretal total

“…Publicações recentes e apresentações em eventos científicos desde 2007 descreveram as aplicações clínicas iniciais do novo método, após aprovação [14][15][16][17] , outros grupos seguiram e publicaram seus resultados clínicos iniciais das técnicas, na maior parte com assistencia laparoscópica para propósito de retração ou visualização [18][19][20][21][22][23][24][25][26][27][28] . Apendicectomia transgástrica foi também apresentada clinicamente em congressos por Rao e Reddy utilizando material endoscópico disponível desde 2005 29 , e recuperação bem-sucedida de gastrostomia foi descrita por Marks e cols 30 .…”

Systematic Review and Meta-analysis of Complications in Transvaginal Approach in Laparoscopic Surgery

“…Many surgical interventions have been shown to be feasible using transvaginal access. Cholecystectomy and appendectomy are being performed in many centers [20,24,38]. Other, less frequently performed interventions include partial colectomy, nephrectomy, gastrectomy, hepatectomy, pancreatectomy, and gynecologic procedures [9,25,26,34,39,40].…”