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Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Cholecystectomy in a Morbidly Obese Patient

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Abstract

Transvaginal natural orifice translumenal endoscopic surgery (NOTES) is a new diagnostic and potentially therapeutic method of surgical endoscopy. The first case of NOTES transvaginal cholecystectomy in a morbid obese patient in the literature is described. IRB approval was obtained at the institution for transvaginal NOTES clinical trials. A 58-year-old female patient with cholelithiasis, hypertension, and type II diabetes, and BMI of 35.8 kg/m2 was submitted to the technique. After transvaginal access, a two-channel gastroscope was introduced into the abdominal cavity along with a laparoscopic trocar. There were 2 umbilical punctures for use of 3 mm laparoscopic equipment. Operative time was 85 min. There was no use of postoperative analgesia, and the patient was discharged on the third postoperative day. Transvaginal NOTES is a feasible alternative method for cholecystectomy in the morbidly obese, although available technology is limited for natural orifice surgery.

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Acknowledgement

We thank for the technical support for experimental and clinical NOTES studies from the Institution of EDLO, Porto Alegre, Brazil.

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Authors and Affiliations

  1. Department of Surgery, Hospital Irmandade Santa Casa da Misericordia, Porto Alegre, Brazil

    Luis DeCarli, Fernando Cirme Lima, Marcos Tang, Sergio Ricardo Pioneer, Idilio Zanin Jr., Alfredo Augusto Schulte & André Vicente Bigolin

  2. Department of Surgery, University Hospital Teresopolis HCTCO-FESO, Av. Américas 13554 BL.1 AP.207, Barra da Tijuca, CEP: 22 790-702, Rio de Janeiro, Brazil

    Ricardo Zorron

  3. Department of Surgery, Cruz Vermelha Hospital Curitiba, Parana, Brazil

    Alcides Branco

  4. Department of Surgery, Mount Sinai Medical Center, Miami, FL, USA

    Michel Gagner

Authors
  1. Luis DeCarli
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  2. Ricardo Zorron
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  3. Alcides Branco
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  4. Fernando Cirme Lima
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  5. Marcos Tang
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  6. Sergio Ricardo Pioneer
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  7. Idilio Zanin Jr.
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  8. Alfredo Augusto Schulte
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  9. André Vicente Bigolin
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  10. Michel Gagner
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Corresponding author

Correspondence to Ricardo Zorron.

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DeCarli, L., Zorron, R., Branco, A. et al. Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Cholecystectomy in a Morbidly Obese Patient. OBES SURG 18, 886–889 (2008). https://doi.org/10.1007/s11695-008-9523-x

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  • DOI: https://doi.org/10.1007/s11695-008-9523-x

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