title: Natural orifice translumenal endoscopic surgery (NOTES) transvaginal cholecystectomy in a morbidly obese patient.
abstract: Transvaginal natural orifice translumenal endoscopic surgery (NOTES) is a new diagnostic and potentially therapeutic method of surgical endoscopy. The first case of NOTES transvaginal cholecystectomy in a morbid obese patient in the literature is described. IRB approval was obtained at the institution for transvaginal NOTES clinical trials. A 58-year-old female patient with cholelithiasis, hypertension, and type II diabetes, and BMI of 35.8 kg/m(2) was submitted to the technique. After transvaginal access, a two-channel gastroscope was introduced into the abdominal cavity along with a laparoscopic trocar. There were 2 umbilical punctures for use of 3 mm laparoscopic equipment. Operative time was 85 min. There was no use of postoperative analgesia, and the patient was discharged on the third postoperative day. Transvaginal NOTES is a feasible alternative method for cholecystectomy in the morbidly obese, although available technology is limited for natural orifice surgery.
authors.affiliation: Department of Surgery, Hospital Irmandade Santa Casa da Misericordia, Porto Alegre, Brazil.
authors.forename: Luis
authors.initials: L
authors.lastname: Decarli
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zorron
authors.forename: Alcides
authors.initials: A
authors.lastname: Branco
authors.forename: Fernando Cirme
authors.initials: FC
authors.lastname: Lima
authors.forename: Marcos
authors.initials: M
authors.lastname: Tang
authors.forename: Sergio Ricardo
authors.initials: SR
authors.lastname: Pioneer
authors.forename: Idilio
authors.initials: I
authors.lastname: Zanin
authors.forename: Alfredo Augusto
authors.initials: AA
authors.lastname: Schulte
authors.forename: André Vicente
authors.initials: AV
authors.lastname: Bigolin
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
mesh_terms: D002763:Cholecystectomy / Q000379:methods*; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery*; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D014621:Vagina / Q000601:surgery*