Magnetic Retraction for NOTES Transvaginal Cholecystectomy

Introduction: Natural orifice surgery (NOTES) has the potential to decrease the burden of an operation on a patient. Limitations of the endoscopic platform require innovative solutions to provide retraction and create an operation comparable to the gold standard, laparoscopic cholecystectomy. Methods: Four patients underwent transvaginal cholecystectomy. All procedures were performed under laparoscopic vision to ensure safety. The endoscope and a long articulating RealHand instrument were placed via a 15mm vaginal trocar. A magnetic retraction system was used to safely retract the gallbladder. Laparoscopic clips were used to ligate the cystic duct and artery. All four gallbladders were successfully removed. There were no complications. Mean operating time was 102 minutes. Results: All four procedures were completed without complication. All four patients were discharged shortly after surgery and reported normal sexual activity without pain. Conclusions: Transvaginal cholecystectomy can be safely completed using current technology. Further studies will be needed to determine the safety of the procedure and determine whether it confers any benefits other than cosmesis.

Session: Podium Presentation

Program Number: V002

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