Angel Cuadrado-García, MD PhD, José F Noguera, MD PhD, Rafael Morales, MD, Carlos Dolz, MD PhD, Jose M Olea, MD, Jose C Vicens, MD PhD, Luis Lozano, MD. Hospital Son Llatzer, Palma de Mallorca. SPAIN.
Background Natural orifice transluminal endoscopic surgery (NOTES) makes it possible to perform intraperitoneal surgical procedures with a minimal number of access points. Currently, it is not possible to perform these interventions without the help of abdominal wall entryways, so these procedures are hybrids. This report presents a prospective clinical series of 150 patients comparing Transvaginal NOTES vs minilaparoscopy.
Methods : The study comprised a clinical series of 75 consecutive nonrandomized women who underwent a transvaginal NOTES cholecystectomy vs a minilaparoscopy procedure control group of 75 female patients
Results :The scheduled surgical intervention was performed for all women. No intraoperative complications occurred. One patient had mild hematuria that resolved in less than 12 h, but no other big complications occurred during an average follow-up period of at least 1 year. No dispareunia was found in NOTES group. Operative time was longer in NOTES group but without stadistical significance. Of the 75 NOTES patients, 65 were discharged in 24 h, and 10 were discharged less than 12 h after the procedure.
Conclusion: Hybrid transvaginal NOTES cholecystectomy and minilaparoscopy are good surgical models for minimally invasive surgery.They can be performed by surgical teams where laparoscopy is practiced regularly and using the instruments normally used for endoscopy. Due to the reproducibility of the intervention and the ease of vaginal closure, hybrid transvaginal procedures are a safe new option for cholecystectomy in women and they will permit further development of NOTES in the future.
Program Number: S054