• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • 2022 NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Trans-Vaginal Organ Extraction: Potential for Broad Clinical Application

Juan S Barajas-Gamboa, MD, Alisa M Coker, MD, Joslin Cheverie, MD, C. Aitor Macias, MD, MPH, Bryan J Sandler, MD, FACS, Garth R Jacobsen, MD, FACS, Mark A Talamini, MD, FACS, Santiago Horgan, MD, FACS

UCSD Center for the Future of Surgery

Introduction
Natural Orifice Transluminal Endoscopic Surgery (NOTES) procedures evolved over the past few years. A trans-vaginal approach is a promising alternative for intraperitoneal procedures. Our objective was to evaluate the safety and feasability of trans-vaginal organ extraction.

Methods and Procedures
This IRB-approved protocol involved retrospective review of an on-going prospective study. Female subjects who presented to our hospital for elective cholecystectomy, appendectomy, or sleeve gastrectomy were offered participation in the study. Eligible patients met the following criteria: ages between 18 and 75, diagnosis of gallbladder disease, acute appendicitis, or morbid obesity who desired surgical treatment. A hybrid natural orifice approach was used in this series. This involved a conventional laparoscopic surgical approach to the disease, followed by trans-vaginal organ extraction at the completion of the procedure. Vaginal access was performed under direct laparoscopic visualization. After dilating the cervix and placing a uterine mobilizer, a 15-mm trocar was placed in the posterior cul-de-sac of the vagina under direct view. An endoscope was then placed through the vaginal trocar with an endoscopic snare for organ extraction. At the conclusion of the case, a single figure-of-eight absorbable stitch was used to close the defect.

Results
Thirty-four women underwent trans-vaginal organ extraction between March 2008 and January 2012. The mean age was 40 years (+/- 12.1) (range 23-63). The mean body mass index (BMI) was 27 (+/- 6.4) (range 16-43). All patients had an ASA classification of 2 or below. The mean operative time for cholecystectomy, appendectomy, and sleeve gastrectomy was 90, 71, and 135 minutes respectively. There were no conversions to open operation and no intraoperative complications. The mean hospital stay was 2 days for all cases. Patients were followed for a mean of 24 months (range 1 – 61). There were 2 pregnancies and 2 successful vaginal deliveries. Six patients (18%) had minor complaints of spotting or heavy menses in the immediate post-operative period that resolved with conservative measures. There were no abdominal wall complications. There were no long-term complications and no mortalities.

Conclusions
This initial experience suggests that this surgical approach is safe, does not increase length of stay, and has no long-term vaginal complications. Given this attractive profile, a trans-vaginal approach may prove to be a superior mode of organ extraction, although randomized studies and long-term follow-up are needed.


Session: Podium Presentation

Program Number: S104

73

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons