Advertisement

Surgical Endoscopy

, Volume 22, Issue 7, pp 1715–1716 | Cite as

Transvaginal laparoscopic cholecystectomy: laparoscopically assisted

  • Marc BesslerEmail author
  • Peter D. Stevens
  • Luca Milone
  • Nancy J. Hogle
  • Evren Durak
  • Dennis Fowler
Video

Abstract

Natural orifice transluminal endoscopic surgery (NOTES) is considered the new frontier for minimally invasive surgery. NOTES procedures such as peritoneoscopy, splenectomy, and cholecystectomy in animal models have been described. The aim of our experiment was to determine the feasibility and technical aspects of a new endoluminal surgical procedure. After approval from Columbia’s IACUC, a transvaginal laparoscopically assisted endoscopic cholecystectomy was performed on four 30 kg Yorkshire pigs. The first step was to insert a 1.5 cm endoscope into the vagina under direct laparoscopic vision. Then the gallbladder was reached and, with the help of a laparoscopic grasper to hold up the gallbladder, the operation was performed. At the end of the procedure the gallbladder was snared out through the vagina attached to the endoscope. There were no intraoperative complications such as bleeding, common bile duct or endo-abdominal organ damage. Total operative time ranged between 110 and 155 min. Based on our experience in the porcine model, we believe that a transvaginal endoscopic cholecystectomy is feasible in humans.

Keywords

NOTES Cholecystectomy Pig model 

Supplementary material

(MOV 141667 kb)

References

  1. 1.
    Rao and Reddy (2006) Transgastric appendectomy in humans. No publication. Presentation at World Congress of Gastroenterology, Montreal, Sept 2006Google Scholar
  2. 2.
    Kalloo AN, Singh VK, Jagannath SB et al (2004) Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60:114–117PubMedCrossRefGoogle Scholar
  3. 3.
    De La Fuente SG, DeMaria EJ, Reynolds JD, Portenier DD, Pryor AD (2007) New developments in surgery: natural orifice transluminal endoscopic surgery (NOTES). Arch Surg 142(3):295–297CrossRefGoogle Scholar
  4. 4.
    Kantsevoy SV, Hu S, Kalloo AN et al (2006) Transgastric endoscopic splenectomy. Is it possible? Surg Endosc 20: 522–525PubMedCrossRefGoogle Scholar
  5. 5.
    Pai RD, Fong DG, Bundga ME, Odze RD, Rattner DW, Thompson CC (2006) Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model (with video). Gastrointest Endosc 64(3):428–434PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Marc Bessler
    • 1
    Email author
  • Peter D. Stevens
    • 2
  • Luca Milone
    • 1
  • Nancy J. Hogle
    • 3
  • Evren Durak
    • 1
  • Dennis Fowler
    • 3
  1. 1.Department of SurgeryColumbia University College of Physicians and SurgeonsNew YorkUSA
  2. 2.Division of Digestive and Liver Diseases, Department of MedicineColumbia University College of Physician and SurgeonsNew YorkUSA
  3. 3.Department of Surgery, Minimal Access Surgery CenterColumbia University College of Physicians and SurgeonsNew YorkUSA

Personalised recommendations