title: Emergency transvaginal hybrid natural orifice transluminal endoscopic surgery.
abstract: In a clinical series, 10 consecutive female patients with intra-abdominal infections were successfully treated with natural orifice transluminal endoscopic surgery (NOTES) performed transvaginally. The surgery, which consisted of a hybrid NOTES procedure using a transvaginal approach, was performed on an emergency basis by the surgical team on call. The indications for surgery were acute cholecystitis (n = 6), acute appendicitis (n = 2), and pelvic peritonitis (n = 2) with intra-abdominal infection. The procedure was successfully performed in all patients using a dual-channel endoscope and mini-laparoscopy assistance. This is the first clinical series in which NOTES has been performed on an emergency basis to treat intra-abdominal infections. Transvaginal surgery for intra-abdominal infection is a feasible procedure for groups experienced in the elective NOTES approach.
authors.affiliation: Department of Surgery, Hospital Son Llàtzer, Carretera de Manacor km. 4, Palma de Mallorca, Spain. jnoguera@hsll.es
authors.forename: J F
authors.initials: JF
authors.lastname: Noguera
authors.forename: A
authors.initials: A
authors.lastname: Cuadrado
authors.forename: F M
authors.initials: FM
authors.lastname: Sánchez-Margallo
authors.forename: C
authors.initials: C
authors.lastname: Dolz
authors.forename: J M
authors.initials: JM
authors.lastname: Asencio
authors.forename: J M
authors.initials: JM
authors.lastname: Olea
authors.forename: R
authors.initials: R
authors.lastname: Morales
authors.forename: L
authors.initials: L
authors.lastname: Lozano
authors.forename: J C
authors.initials: JC
authors.lastname: Vicens
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery; D002763:Cholecystectomy / Q000379:methods*; D041881:Cholecystitis, Acute / Q000601:surgery; D005260:Female; D006801:Humans; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D010533:Peritoneal Lavage / Q000379:methods; D010538:Peritonitis / Q000601:surgery; D016896:Treatment Outcome; D014621:Vagina