title: Transumbilical endoscopic surgery: a preliminary clinical report.
abstract: OBJECTIVE
  There has been great interest in natural orifice transluminal endoscopic surgery (NOTES) in recent years. We report another new approach--transumbilical endoscopic surgery (TUES)--which we have performed in 40 cases for liver cysts (3), bleeding ascites (1), chronic appendicitis (10), and gallbladder diseases (26).
  
  
  METHODS
  Transumbilical endoscopic liver cyst fenestration, abdominal cavity exploration, appendectomy, and cholecystectomy were performed in a total of 40 patients.
  
  
  RESULTS
  All the operations were completed successfully except one case of intraoperative bleeding in TUES cholecystectomy which was converted to routine laparoscopic surgery. The operating times for TUES cholecystectomy, appendectomy, and liver cyst fenestration were 30-150 min,15-40 min, and 30-90 min, respectively. No postoperative bleeding or bile leakage occurred in this group of patients.
  
  
  CONCLUSIONS
  Transumbilical endoscopic surgery is feasible, and would be another option for scarless abdominal surgery. TUES cholecystectomy is technically challenging. Careful selection of patients is important in the initial period of this technique.
authors.affiliation: Department of General Surgery, East Hospital of Tongji University, 150 Ji Mo Road, 200120 Pudong, Shanghai, China. zhujiangfan@hotmail.com
authors.forename: Jiang Fan
authors.initials: JF
authors.lastname: Zhu
authors.forename: Hai
authors.initials: H
authors.lastname: Hu
authors.forename: Ying Zhang
authors.initials: YZ
authors.lastname: Ma
authors.forename: Man Zhu
authors.initials: MZ
authors.lastname: Xu
authors.forename: Feng
authors.initials: F
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery; D002763:Cholecystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008107:Liver Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus; D055815:Young Adult