Surgical Endoscopy

, Volume 26, Issue 3, pp 877–881 | Cite as

Totally transvaginal resection of the descending colon in an experimental model

  • Francisco Alba Mesa
  • Antonio Amaya Cortijo
  • Jose Manuel Romero Fernandez
  • Andrzej L. KomorowskiEmail author
  • Miguel Angel Sanchez Hurtado
  • Francisco Miguel Sanchez Margallo
New Technology



Natural orifice translumenal endoscopic surgery (NOTES), although in its embryonic phase, is currently experiencing important developments. The technique has been successfully applied for cholecystectomies and appendectomies. However, several doubts exist as to the technical limitations and feasibility of NOTES in other clinical settings.


The authors have performed totally transvaginal colon resections in a sheep model. Although completion of the surgery was possible through the transvaginal route, the addition of a transumbilical laparoscope was used as an added safety measure.


Totally transvaginal resection of the sigmoid colon was performed for two sheep with no intra- or postoperative complications.


Totally transvaginal resection of the colon (pure NOTES) is feasible in a sheep model.


Colon resection Experimental animal model Laparoscopy NOTES Single port 



Andrzej L. Komorowski declares receiving course, congress, and travel fees from Ethicon Spain and Karl Storz Germany. Francisco Alba Mesa, Antonio Amaya Cortijo, Jose Manuel Romero Fernandez, Miguel Angel Sanchez Hurtado, and Francisco Miguel Sanchez Margallo have no conflicts of interest or financial ties to disclose.


  1. 1.
    Bessler M, Gumbs AA, Milone L, Evanko JC, Stevens P, Fowler D (2010) Pure natural orifice transluminal endoscopic surgery (NOTES) cholecystectomy (video). Surg Endosc 24:2316–2317PubMedCrossRefGoogle Scholar
  2. 2.
    Lacy AM, Delgado S, Rojas OA, Almenara R, Blasi A, Llach J (2008) MA-NOS radical sigmoidectomy: report of a transvaginal resection in the human. Surg Endosc 22:1717–1723PubMedCrossRefGoogle Scholar
  3. 3.
    Alba Mesa F, Romero Fernandez JM, Komorowski AL, Amaya Cortijo A (2010) Postoperative pain after laparoscopic assisted transvaginal resection of rectal cancer (abstract no. 385). Eur J Surg Oncol 36:885–886Google Scholar
  4. 4.
    Bucher P, Pugin F, Morel P (2010) Transumbilical single-incision laparoscopic sigmoidectomy for benign disease. Colorectal Dis 12:61–65PubMedCrossRefGoogle Scholar
  5. 5.
    Bucher P, Pugin F, Morel P (2009) Single-port-access laparoscopic radical left colectomy in humans. Dis Colon Rectum 52:1797–1802PubMedCrossRefGoogle Scholar
  6. 6.
    Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826PubMedCrossRefGoogle Scholar
  7. 7.
    Horgan S, Cullen JP, Talamini MA, Mintz Y, Ferreres A, Jacobsen GR, Sandler B, Bosia J, Savides T, Easter DW, Savu MK, Romamoorthy SL, Withcomb E, Agarval S, Lukacz E, Dominguez G, Ferraina P (2009) Natural orifice surgery: initial clinical experience. Surg Endosc 23:1512–1518PubMedCrossRefGoogle Scholar
  8. 8.
    Sohn BS, Kim SR, Park IY, Kim EJ (2010) Transvaginal laparoscopic cholecystectomy (hybrid NOTES cholecystectomy). J Laparoendosc Adv Surg Tech A 20:245–247PubMedCrossRefGoogle Scholar
  9. 9.
    Sanchez Margallo FM, Perez Duarte FJ, Sanchez Hurtado MA (2010) A new ovine model of hybrid natural orifice translumenal endoscopic surgery (NOTES) nephrectomy (abstract no. 6). Minim Invasive Ther 19(Suppl 1):11–12Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Francisco Alba Mesa
    • 1
  • Antonio Amaya Cortijo
    • 1
  • Jose Manuel Romero Fernandez
    • 1
  • Andrzej L. Komorowski
    • 2
    Email author
  • Miguel Angel Sanchez Hurtado
    • 3
  • Francisco Miguel Sanchez Margallo
    • 3
  1. 1.Consorcio Sanitario Publico del AljarafeHospital San Juan de DiosBormujos (Sevilla)Spain
  2. 2.Servicio de Cirugia GeneralHospital Virgen del CaminoSanlúcar de Barrameda (Cadiz)Spain
  3. 3.Department of Laparoscopic SurgeryMinimally Invasive Surgery Centre Jesús UsónCáceres (Caceres)Spain

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