Transvaginal Natural Orifice Translumenal Endoscopic Surgery Cholecystectomy

• DOI: 10.1097/sla.0b013e3181a802e2
• Publication Date: 2009-06-01T07:37:49Z
• Authors: Andrew A. Gumbs; Dennis Fowler; Luca Milone; John C. Evanko; Akuezunkpa O. Ude; Peter Stevens; Marc Bessler
• Keywords: CLIPS; Retractor

In Brief Introduction: Initial excitement for Natural Orifice Transluminal Endoscopic Surgery (NOTES) has been partly tempered by the reality that a NOTES procedure without laparoscopic or needleoscopic-assistance not performed most groups. After safely performing laparoscopically-assisted transvaginal cholecystectomy in an IACUC-approved porcine model, we embarked on IRB-approved protocol to ultimately perform pure cholecystectomy. Materials and Methods: We describe our experience with true tansvaginal after accomplishing 3 hybrid procedures humans. To overcome retracting limitations of currently available endoscopes, used 5-mm curved articulating retractor was placed into abdomen via separate colpotomy second third patient. fourth patient, pneumoperitoneum 15 torr obtained trocar through made under direct vision endoscopically clips were both cystic duct artery, thus, obviating need any transabdominally instruments needles. Results: This patient first undergo completely at institution knowledge United States. She discharged day surgery suffered complication 1 month follow-up. Conclusion: Pure aid needleoscopic is feasible safe Additional this technique will be required before comparative studies standard laparoscopy techniques are appropriate.