Transvaginal rigid-hybrid natural orifice transluminal endoscopic surgery technique for anterior resection treatment of diverticulitis: a feasibility study

Tarantino, Ignazio; Linke, Georg R.; Lange, Jochen; Siercks, Ikbale; Warschkow, René; Zerz, Andreas

doi:10.1007/s00464-011-1666-5

Cited by 30 publications

(15 citation statements)

References 36 publications

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“…These included five case reports [16–18, 23, 26] and eight case series [14, 15, 19–22, 24, 25]. There was no reported incision site herniation or tumour recurrence among these 143 patients.…”

Section: Resultsmentioning

confidence: 99%

Specimen retrieval approaches in patients undergoing laparoscopic colorectal resections: a literature-based review of published studies

Sajid

Bhatti

Sains

et al. 2014

Gastroenterology Report

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Objective: To review the published studies reporting various specimen retrieval incisions being used by colorectal surgeons in patients undergoing laparoscopic colorectal resections (LCR).Methods: Standard medical electronic databases were searched to find relevant articles and a summary conclusion was generated.Results: There were 43 studies reporting various approaches used for the purpose of specimen retrieval in 2388 patients undergoing LCR. The most common approaches were periumbilical midline incision (1260 reported case in the literature), transverse incision (583 reported cases in the literature) in the right- or left iliac fossa, depending on the side of colonic resection, and Pfannensteil incision (293 reported cases in the literature). Periumbilical midline incision was associated with the higher risk of developing incisional hernia (odds ratio 53.72; 95% confidence interval 7.48–386.04; Z = 3.96; P = 0.0001). In terms of surgical site infection (SSI), there was no difference between the three common approaches to specimen retrieval. Transanal and transvaginal approaches were associated with higher risk of SSI.Conclusions: Midline, transverse and Pfannensteil incisions were the most commonly used approaches for specimen retrieval following LCR. Midline incision was associated with higher risk of incisional hernia. Risk of SSI was similar in all three common approaches. The transanal and transvaginal approaches pose a higher risk of SSI. These conclusions are based on the combined outcome of published case series, case reports and comparative studies. Randomized, controlled trials with longer follow-up are required before recommending the routine use of any approach for specimen retrieval in patients undergoing LCR.

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Section: Resultsmentioning

confidence: 99%

Specimen retrieval approaches in patients undergoing laparoscopic colorectal resections: a literature-based review of published studies

Sajid

Bhatti

Sains

et al. 2014

Gastroenterology Report

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“…A total of 100to 150 female patients are expected to be referred for elective surgery for diverticulitis. Based on the experiences in our previous study, we expect a recruitment rate of 60 to 70% [ 11 ]. Recruitment strategies, such as provisions or financial compensation, are not intended.…”

Section: Methodsmentioning

confidence: 99%

“…Based on gynecological experience, transvaginal access was the first transluminal access and advanced to the most frequently applied route for NOTES [ 7 ]. Several studies have confirmed the feasibility and safety of transvaginal cholecystectomy [ 5 , 6 , 8 ] and colonic resection [ 10 , 11 ] using the hybrid NOTES approach.…”

Section: Introductionmentioning

confidence: 99%

The transvaginal hybrid NOTES versus conventionally assisted laparoscopic sigmoid resection for diverticular disease (TRANSVERSAL) trial: study protocol for a randomized controlled trial

Senft

Warschkow

Tarantino

et al. 2014

Trials

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BackgroundNatural orifice transluminal endoscopic surgery (NOTES) is the consequence of further development of minimally invasive surgery to reduce abdominal incisions and surgical trauma. The potential benefits are expected to be less postoperative pain, faster convalescence, and reduced risk for incisional hernias and wound infections compared to conventional methods. Recent clinical studies have demonstrated the feasibility and safety of transvaginal NOTES, and transvaginal access is currently the most frequent clinically applied route for NOTES procedures. However, despite increasing clinical application, no firm clinical evidence is available for objective assessment of the potential benefits and risks of transvaginal NOTES compared to the current surgical standard.MethodsThe TRANSVERSAL trial is designed as a randomized controlled trial to compare transvaginal hybrid NOTES and laparoscopic-assisted sigmoid resection. Female patients referred to elective sigmoid resection due to complicated or reoccurring diverticulitis of the sigmoid colon are considered eligible. The primary endpoint will be pain intensity during mobilization 24 hours postoperatively as measured by the blinded patient and blinded assessor on a visual analogue scale (VAS). Secondary outcomes include daily pain intensity and analgesic use, patient mobility, intraoperative complications, morbidity, length of stay, quality of life, and sexual function. Follow-up visits are scheduled 3, 12, and 36 months after surgery. A total sample size of 58 patients was determined for the analysis of the primary endpoint. The confirmatory analysis will be performed based on the intention-to-treat (ITT) principle.DiscussionThe TRANSVERSAL trial is the first study to compare transvaginal hybrid NOTES and conventionally assisted laparoscopic surgery for colonic resection in a randomized controlled setting. The results of the TRANSVERSAL trial will allow objective assessment of the potential benefits and risks of NOTES compared to the current surgical standard for sigmoid resection.Trial registrationThe trial protocol was registered in the German Clinical Trials Register ( DRKS00005995) on March 27, 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/1745-6215-15-454) contains supplementary material, which is available to authorized users.

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“…17 A series of hybrid transvaginal-low anterior resections for diverticulitis also did not demonstrate a change in female sexual function postoperatively. 18 Finally, within the gynecology literature, several studies have found no significant difference in sexual function after transvaginal hysterectomy compared with laparoscopic hysterectomy. [19][20][21] It has been argued that the vaginal anatomy, with minimal sensory innervation of the upper vagina, may explain why female sexual function is not affected by a transvaginal procedure.…”

Section: Sexual Functionmentioning

confidence: 99%

Transvaginal Cholecystectomy

Wood¹,

Solomon²,

Panait³

et al. 2013

JAMA Surg

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Transvaginal rigid-hybrid natural orifice transluminal endoscopic surgery technique for anterior resection treatment of diverticulitis: a feasibility study

Abstract: For symptomatic diverticular disease, TvAR is feasible, although the presented technique requires laparoscopic expertise and further refinement.

Cited by 30 publications

References 36 publications

Specimen retrieval approaches in patients undergoing laparoscopic colorectal resections: a literature-based review of published studies

Specimen retrieval approaches in patients undergoing laparoscopic colorectal resections: a literature-based review of published studies

The transvaginal hybrid NOTES versus conventionally assisted laparoscopic sigmoid resection for diverticular disease (TRANSVERSAL) trial: study protocol for a randomized controlled trial

Transvaginal Cholecystectomy

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