title: [Transvaginal appendectomy with traditional laparoscopic tools].
abstract: OBJECTIVE
  To establish the technique and methodology of appendectomy through transvaginal natural orifice transluminal endoscopic surgery(NOTES)under laparoscopy.
  
  
  METHODS
  Three cases of chronic appendicitis were selected to receive laparoscopic transvaginal resection of appendixes with concurrent vaginal hysterectomies for uterine fibroids at Shengjing Hospital of China Medical University from November 2010 to November 2011. The procedure was performed by a multidisciplinary team composed of surgeons and gynecologists. The clinical data such as operative duration, bleeding volume, morbidity and stay duration were collected and analyzed.
  
  
  RESULTS
  Appendectomies were performed with the working laparoscopic tools inserted through vagina. The en bloc resection was removed transvaginally through laparoscope. It took 34, 23 and 26 minutes respectively to complete the appendectomies. And the blood loss volume was minimal. There were no postoperative complications. And the patients were discharged scar-free after 3 days.
  
  
  CONCLUSIONS
  Transvaginal appendectomy is both feasible and safe when performed by a multidisciplinary team. As an emerging innovation, natural orifice transluminal endoscopic surgery is mini-invasive, better tolerated and more respectful of esthetics.
authors.affiliation: Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Tian
authors.forename: Shuo-dong
authors.initials: SD
authors.lastname: Wu
authors.forename: Dan-bo
authors.initials: DB
authors.lastname: Wang
authors.forename: Ying-han
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery