title: Laparoscopy and natural orifice surgery: first entry safety surveillance step.
abstract: OBJECTIVE
  We are sharing information regarding the surveillance of the first entrance port in laparoscopic and natural orifice transvaginal endoscopy surgeries. However, we are not analyzing techniques or other surgical findings.
  
  
  METHODS
  In this study, 160 women with previous abdominal pelvic surgeries underwent laparoscopic surgery, 145 patients underwent transvaginal Minilaparoscopy Assisted Natural Orifice Surgery (hybrid), and 3 patients underwent pure natural orifice transvaginal endoscopic surgery (pure). For those patients who had laparoscopy and hybrid procedures, the surveillance was from a laparoscope or gastroscope placed in a secondary port. Surveillance in pure cases was done using a gastroscopic retro view to see the pouch of Douglas.
  
  
  RESULTS
  The laparoscopic procedures were gynecological procedures. The hybrid procedures included gynecological procedures as well as appendectomies and cholecystectomies; the pure procedures were cholecystectomies. There were a few minor vascular and bowel injuries in the laparoscopy group. There were no injuries in the transvaginal hybrid or pure procedures groups.
  
  
  CONCLUSIONS
  The surveillance of the first entrance port can be an effective precautionary step. The cumulative experience suggests that using such surveillance in cases involving patients with prior surgery may assist in recognizing complications that might otherwise be missed.
authors: The Mount Sinai Hospital of Queens, Long Island City, New York, USA. LaserGYN@aol.com
authors: Daniel A
authors: DA
authors: Tsin
authors: Andrea
authors: A
authors: Tinelli
authors: Antonio
authors: A
authors: Malvasi
authors: Fausto
authors: F
authors: Davila
authors: Ramiro
authors: R
authors: Jesus
authors: Raul
authors: R
authors: Castro-Perez
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies