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.
Similar content being viewed by others
References
Rao and Reddy (2006) Transgastric appendectomy in humans. No publication. Presentation at World Congress of Gastroenterology, Montreal, Sept 2006
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 60:114–117
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):295–297
Kantsevoy SV, Hu S, Kalloo AN et al (2006) Transgastric endoscopic splenectomy. Is it possible? Surg Endosc 20: 522–525
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):428–434
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
(MOV 141667 kb)
Rights and permissions
About this article
Cite this article
Bessler, M., Stevens, P.D., Milone, L. et al. Transvaginal laparoscopic cholecystectomy: laparoscopically assisted. Surg Endosc 22, 1715–1716 (2008). https://doi.org/10.1007/s00464-008-9779-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-008-9779-1