Hybrid Transvaginal Cholecystectomy: Initial Clinical Experience at a Military Institution

Gordon Wisbach, MD, Kyle Gadbois, MD, Kristin Stevens, MD, Amanda Simsiman, MD. Naval Medical Center San Diego


INTRODUCTION: We present our initial clinical experience applying Natural Orifice Transluminal Endoscopic Surgical (NOTES) technique to perform cholecystectomy in a military institution.

METHODS:  IRB-appoval was obtained to perform this prospective study. Six women with an indication for cholecystectomy were enrolled. Inclusion criteria included ASA classification 1 as well as no previous abdominal surgery or gynecology disorders.  All patients were examined by gynecology prior to operation.

RESULTS: Six women underwent a hybrid transvaginal cholecystectomy with one operation requiring an intra-operative cholangiogram. The average age was 28 y.o (22-35), Indications for surgery included symptomatic cholelithiasis (4), r/o choledocolithiasis (1) and biliary colic (1). Average OR time was 140 mins (120-210) and blood loss was 10 cc (5-30). There were no conversions and the average LOS was 6 hrs (4-10). Pain scale on POD #7 was none or minimal and was related to the trans-umbilical incision only.  All women stated that they would recommend the procedure to another patient. 

CONCLUSION: Application of the NOTES technique to cholecystectomy can be safely and effectively performed. Military benefits may include earlier return to work for the service member and the ability to perform intra-abdominal surgery in an austere environment.


Session Number: VidTV1 – Video Channel Rotation Day 1
Program Number: V094

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