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NOTES and Endoluminal Surgery pp 191–200Cite as

Flexible Endoscopic Transvaginal Cholecystectomy

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Part of the book series: Clinical Gastroenterology ((CG))

Abstract

One of the first human NOTES cases reported in the literature was that of transvaginal cholecystectomy. Although early attempts at human NOTES were primarily via the transgastric route, surgeons quickly realized that the transgastric route to the gallbladder was complicated by the need to be in the retroflexed position for the duration of the case. Transvaginal cholecystectomy, on the other hand, presented forward access to the gallbladder, which was technically much simpler to achieve and potentially safer for the patients. While both rigid and flexible endoscopic approaches to the gallbladder are well described, this chapter focuses on flexible endoscopic surgical technique. Transvaginal surgery also had the advantage of facile access to the abdomen without the need for visceral closure. There are multiple published case reports and small series describing good results with flexible endoscopic transvaginal surgery. The author’s own series is also detailed. A recent, multicenter, randomized trial comparing transvaginal cholecystectomy with laparoscopic cholecystectomy successfully showed that the transvaginal approach was non-inferior. Although the results show that this approach to gallbladder surgery is safe and effective, issues of time, instrument availability, and cost continue to hinder its widespread adoption.

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Authors and Affiliations

  1. Department of Surgery, Tufts University School of Medicine, Baystate Medical Center, 759 Chestnut Street, S3656, Springfield, MA, 01199, USA

    John R. Romanelli

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  1. John R. Romanelli
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Correspondence to John R. Romanelli .

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Editors and Affiliations

  1. Department of Surgery, University of Massachusetts / Baystate Medical Center, Springfield, Massachusetts, USA

    John R. Romanelli

  2. Division of Gastroenterology, University of Massachusetts / Baystate Medical Center, Springfield, Massachusetts, USA

    David J. Desilets

  3. Lowell Surgical Associates , North Chelmsford, Massachusetts, USA

    David B. Earle

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Romanelli, J.R. (2017). Flexible Endoscopic Transvaginal Cholecystectomy. In: Romanelli, J., Desilets, D., Earle, D. (eds) NOTES and Endoluminal Surgery. Clinical Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-50610-4_16

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  • DOI: https://doi.org/10.1007/978-3-319-50610-4_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50608-1

  • Online ISBN: 978-3-319-50610-4

  • eBook Packages: MedicineMedicine (R0)

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