NOTES Transvaginal Hernia Repair with Alloderm Mesh

Introduction: Natural Orifice Translumenal Endoscopic Surgery (NOTES) is a new technique for completing operations by using the body’s natural orifices. Patients with abdominal wall hernias are one subset of patients that may benefit from NOTES therapy as standard surgical techniques may create more hernias for these patients. Methods: Two 35 kg pigs underwent a ventral hernia repair using Alloderm biological mesh (LifeCell, Branchburg, New Jersey, USA) in a hybrid NOTES fashion. Stitches of alternating colors were placed in the mesh extra-corporeally. Under direct laparoscopic vision, an incision was made in the vaginal wall and the mesh was placed transvaginally via this trocar into the abdomen. A combination of an endoscopic grasper and suture passer were used to secure the trans fascial sutures on the mesh under endoscopic view. Results: Both operations were successfully in the mesh placement using this novel technique. Operative time was 60 minutes. Conclusions: NOTES hernia repair with Alloderm is feasible in an animal model. Survival studies are needed to determine the safety, efficacy, and incorporation of mesh using this approach.

Session: Podium Video Presentation

Program Number: V054

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