Abstract
Introduction:
Natural orifice translumenal endoscopic surgery (NOTES) is moving into the clinical arena with multiple feasibility trials taking place around the world. Early results appear encouraging, and the transvaginal access route appears most favored owing to its established safety parameters in gynecological surgery. After extensive simulator, ex vivo, in vivo, and clinical research, ethical approval was granted to evaluate feasibility and clinical outcomes of transvaginal hybrid NOTES cholecystectomy at Imperial College.
Methods:
A 21-year-old woman with a 1-year history of uncomplicated biliary colic confirmed on ultrasound scan and magnetic resonance cholangiopancreatography was counseled for inclusion in the trial. The patient had no relevant medical history and is the mother of a 2-year-old daughter.
Results:
On June 4, 2010, the patient underwent the first UK transvaginal hybrid NOTES cholecystectomy. The operation was performed by a multidisciplinary team in minimally invasive surgery, gynecology, and interventional endoscopy. The operation lasted 127 minutes and there were no perioperative complications or morbidity. The patient received paracetamol analgesia only and was discharged on postoperative day 1. At 1-month follow-up there were no abdominal or gynecological symptoms and no visible abdominal scars.
Conclusion:
Transvaginal hybrid NOTES cholecystectomy appears feasible and was performed safely in this first case with satisfactory outcomes. Further evaluation of this feasibility study will involve recruitment of up to 60 patients.
No competing financial interests exist.
Runtime of video: 5 mins
Keywords
Get full access to this article
View all access options for this article.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
