New hybrid approach for NOTES transvaginal cholecystectomy: preliminary clinical experience.
OBJECTIVE
Natural orifice translumenal endoscopic surgery (NOTES) represents the first step toward scar-less surgery. The objective of this study is to evaluate early clinical results of transvaginal cholecystectomy using a new technique.


METHODS
Institutional review board approval was obtained and transvaginal NOTES cholecystectomy was performed in 12 women for cholelithiasis. A 2-channel videoendoscope was inserted in the abdominal cavity through a posterior colpotomy. Two 3-mm trocars were inserted deep in the umbilicus, and a 10-mm trocar was placed through the colpotomy parallel to the endoscope. Dissection was performed with endoscopic instruments combined with 3-mm laparoscopic instruments.


RESULTS
Mean operative time was 125.8 minutes. All procedures occurred without intraoperative complications or conversions, except for 1 vulvar laceration. There were no postoperative complications in the clinical follow-up.


CONCLUSIONS
Transvaginal NOTES is a feasible and safe alternative for cholecystectomy in this preliminary clinical experience, allowing good cosmetic benefits and low analgesic requirement.
Decarli
Luiz Alberto
LA
Department of Surgery, Hospital Irmandade Santa Casa da Misericordia Porto Alegre, Porto Alegre, Brazil. luizdecarli@vanet.com.br
Zorron
Ricardo
R
Branco
Alcides
A
Lima
Fernando Cirme
FC
Tang
Marcos
M
Pioneer
Sergio Ricardo
SR
Sanseverino
José Inácio
JI
Menguer
Rodrigo
R
Bigolin
André Vicente
AV
Gagner
Michel
M
D015992:Body Mass Index; D002763:Cholecystectomy / Q000379:methods*; D002769:Cholelithiasis / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D020884:Colpotomy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D013536:Suture Techniques; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery; D014621:Vagina / Q000601:surgery*