Surgical Endoscopy

, Volume 22, Issue 6, pp 1427–1429 | Cite as

Scarless cholecystectomy with combined transvaginal and transumbilical approach in a series of 20 patients

  • C. ZornigEmail author
  • H. Mofid
  • A. Emmermann
  • M. Alm
  • H.-A. von Waldenfels
  • C. Felixmüller



Laparoscopic surgery has dramatically improved surgical care of patients reducing postoperative pain, wound infection rate, hospital stay, inability to work, risk of hernia, and cosmetic result. Natural orifice transluminal endoscopic surgery (NOTES) is even less traumatic to the abdominal wall and might further improve minimal invasive surgery of patients, but might also increase surgical risk when used by a transgastric or transcolonic approach with flexible endoscopes. Therefore we decided to use a transvaginal approach using rigid laparoscopic instruments for cholecystectomies.


Through a 5-mm incision deep in the umbilicus a pneumoperitoneum was created. The optic and a dissector were inserted through the posterior fornix of the vagina under laparoscopic control from the umbilicus and a transvaginal gallbladder removal was performed.


20 patients were successfully operated in a 4.5-month period. Operating time was 62 (35–100) min. No intra- or postoperative complications occurred in any patient. Gynecological examination after 8 days showed no negative findings and the cosmetic result was ideal with no visible scars.


In our series we showed that cholecystectomies can be routinely performed in a NOTES technique without visible scar. The transvaginal approach is the safe in NOTES and common laparoscopic instruments can be used as long as there are no better flexible endoscopes for this purpose.


Flexible Endoscope Visible Scar Transvaginal Approach Average Operation Time Posterior Fornix 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • C. Zornig
    • 1
    Email author
  • H. Mofid
    • 1
  • A. Emmermann
    • 1
  • M. Alm
    • 1
  • H.-A. von Waldenfels
    • 2
  • C. Felixmüller
    • 2
  1. 1.Department of SurgeryIsraelitisches KrankenhausHamburgGermany
  2. 2.Praxisklinik Winterhude for Gynecology and ObstetricsHamburgGermany

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