title: Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus.
abstract: Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient's postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures.
authors.affiliation: Department of Surgery, Japanese Red Cross Maebashi Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma 371-0014, Japan.
authors.forename: Takuya
authors.identifier: 0000-0003-3543-1874
authors.initials: T
authors.lastname: Shiraishi
authors.affiliation: Department of Surgery, Japanese Red Cross Maebashi Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma 371-0014, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tomizawa
authors.affiliation: Department of Surgery, Japanese Red Cross Maebashi Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma 371-0014, Japan.
authors.forename: Tatsumasa
authors.initials: T
authors.lastname: Andoh
authors.affiliation: Department of Surgery, Japanese Red Cross Maebashi Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma 371-0014, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Arakawa
authors.affiliation: Department of Surgery, Japanese Red Cross Maebashi Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma 371-0014, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Enokida
authors.affiliation: Department of Surgery, Japanese Red Cross Maebashi Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma 371-0014, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Ozawa