title: Transumbilical multiport laparoscopic nephrectomy with specimen extraction through the vagina.
abstract: OBJECTIVE
  To report our initial experience with transumbilical multiport laparoscopic nephrectomy (TMLN) with transvaginal specimen extraction.
  
  
  METHODS
  Between January and July 2010, 5 married and parous female patients were submitted to TMLN with transvaginal specimen extraction in our center. All data referring to patient demographics, surgery, pathology and perioperative outcomes were recorded. Sexual function was assessed with the Female Sexual Function Index questionnaire before and after surgery. The cosmetic result was investigated by administering the Patient Scar Assessment Questionnaire and Scoring System (PSAQ).
  
  
  RESULTS
  All procedures were completed successfully. The mean operative time was 136 min (range 110-160 min, standard deviation [SD] 20.7). The mean estimated blood loss was 66 ml (range 40-100 ml, SD 24.1). The mean postoperative hospitalization stay was 4.8 days (range 4-6 days, SD 0.8). All patients reported unaltered sexual function after surgery. The better cosmetic results were confirmed by the PSAQ score.
  
  
  CONCLUSIONS
  TMLN with transvaginal specimen extraction is feasible and safe for married and parous female patients. This technique is a natural evolution towards natural orifice transluminal endoscopic surgery (NOTES). By acting as an intermediate-type procedure, it provides a bridge through which NOTES may ultimately gain clinical acceptance.
authors.affiliation: Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, PR China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zou
authors.forename: Guoxi
authors.initials: G
authors.lastname: Zhang
authors.forename: Yijun
authors.initials: Y
authors.lastname: Xue
authors.forename: Yuanhu
authors.initials: Y
authors.lastname: Yuan
authors.forename: Rihai
authors.initials: R
authors.lastname: Xiao
authors.forename: Gengqing
authors.initials: G
authors.lastname: Wu
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Wang
authors.forename: Yuting
authors.initials: Y
authors.lastname: Wu
authors.forename: Dazhi
authors.initials: D
authors.lastname: Long
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.forename: Folin
authors.initials: F
authors.lastname: Liu
authors.forename: Min
authors.initials: M
authors.lastname: Liu
mesh_terms: D000328:Adult; D002921:Cicatrix; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D014621:Vagina / Q000601:surgery*