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Surgical Endoscopy

, Volume 25, Issue 4, pp 1281–1286 | Cite as

Transvaginal laparoscopically assisted endoscopic cholecystectomy: preliminary clinical results for a series of 43 cases in China

  • Jun NiuEmail author
  • Wei Song
  • Ming Yan
  • Wei Fan
  • Weibo Niu
  • Enyu Liu
  • Cheng Peng
  • Pengfei Lin
  • Peng Li
  • Abdul Qadir Khan
Article

Abstract

Background

Transvaginal cholecystectomy has been performed successfully at several research institutions worldwide using natural orifice transluminal endoscopic surgery (NOTES) techniques. However, it is a growing new surgical concept in China. Several technical challenges hinder the safe clinical application of NOTES. This study investigated transvaginal endoscopic cholecystectomy performed with the assistance of a single umbilical trocar and achieved helpful initial clinical experience.

Methods

From May 2009 to April 2010, a total of 43 transvaginal human cholecystectomies were performed. A single umbilical trocar was used for safe access and laparoscopic assistance during the operation. After the gallbladder had been removed through the vagina, the colpotomy was closed with absorbable stitches under direct vision. In addition, Student’s t-test was performed for two samples to estimate the superiority of NOTES over a conventional laparoscopic cholecystectomy (LC) operation.

Results

The procedure was successfully completed for all the patients. No intra- or post-operative complications occurred. The patients recovered promptly after surgery, and all were satisfied with ideal cosmetic outcomes. The postoperative pain, hospital stay, and cost of hospitalization with NOTES were much less than with conventional LC operations.

Conclusions

Although endoscopic instruments specifically designed for NOTES are not available, the addition of an umbilical trocar is an optimal way to allow safe performance of NOTES procedures in an easily reproducible manner. The authors’ initial experience demonstrates that this hybrid technique is potentially feasible and effective for reducing postoperative pain and recovery times while improving the cosmetic results of transvaginal cholecystectomy.

Keywords

Cholecystectomy Endoscopy Laparoscopy NOTES Transvaginal 

Notes

Disclosures

Jun Niu, Wei Song, Ming Yan, Wei Fan, Weibo Niu, Enyu Liu, Cheng Peng, Pengfei Lin, Peng Li, and Abdul Qadir Khan have no conflicts of interests or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jun Niu
    • 1
    Email author
  • Wei Song
    • 3
  • Ming Yan
    • 1
    • 2
  • Wei Fan
    • 1
    • 2
  • Weibo Niu
    • 1
    • 2
  • Enyu Liu
    • 1
    • 2
  • Cheng Peng
    • 1
    • 2
  • Pengfei Lin
    • 1
    • 2
  • Peng Li
    • 4
  • Abdul Qadir Khan
    • 1
    • 2
  1. 1.Department of Hepatobiliary SurgeryQilu Hospital of Shandong University, the Institute of Laparoscopic Minimally Invasive Surgery of Shandong UniversityJinanPeople’s Republic of China
  2. 2.The Institute of Laparoscopic Minimally Invasive Surgery of Shandong UniversityJinanPeople’s Republic of China
  3. 3.General Hospital of Yanzhou Mining Group of Shandong ProvinceZouchengPeople’s Republic of China
  4. 4.Department of Obstetrics and GynecologyQilu Hospital of Shandong UniversityJinanPeople’s Republic of China

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