title: NOTES transvaginal video-assisted cholecystectomy: first series.
abstract: OBJECTIVE
  Extensive research has been conducted to develop natural-orifice transluminal endoscopic surgery (NOTES) as a new approach to less invasive surgery. Our aim is to present the technique and initial prospective results of a transvaginal video-assisted laparoscopic approach to NOTES cholecystectomy in order to perform minimally invasive surgery without visible scars.
  
  
  METHODS
  From July 2007 to March 2008, 32 women underwent transvaginal video-assisted laparoscopic cholecystectomy using a transvaginal 10-mm 45 degrees rigid bariatric optic through a 12-mm bariatric trocar and two abdominal trocars (2-mm and 5-mm). Data on the history, surgical time, complications, and recovery were recorded prospectively in each case.
  
  
  RESULTS
  Mean age was 33 years (range 22 - 47 years); mean body mass index was 29 (range 20 - 42). Mean operative time was 38 minutes (range 18 - 50 minutes). Patients were discharged 6 hours after the procedure without the need for pain medication in the following days and returned to normal working activities within 24 hours of the procedure.
  
  
  CONCLUSIONS
  Transvaginal video-assisted NOTES cholecystectomy seems to be an efficient and safe approach to minimally invasive surgery, providing patients with a comfortable recovery with virtually no abdominal scars as a bridge to exclusively NOTES procedures.
authors.affiliation: Gastro Obeso Center, São Paulo, Brazil.
authors.forename: A Cardoso
authors.initials: AC
authors.lastname: Ramos
authors.forename: A
authors.initials: A
authors.lastname: Murakami
authors.forename: M
authors.initials: M
authors.lastname: Galvão Neto
authors.forename: M Santana
authors.initials: MS
authors.lastname: Galvão
authors.forename: A C Souza
authors.initials: AC
authors.lastname: Silva
authors.forename: E Gonzalo
authors.initials: EG
authors.lastname: Canseco
authors.forename: Y
authors.initials: Y
authors.lastname: Moyses
mesh_terms: D000328:Adult; D002763:Cholecystectomy / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D014621:Vagina; D020535:Video-Assisted Surgery / Q000379:methods*