Background: NOTES is the newest technique emerging in the field of surgery. We describe the transvaginal approach for endoscopic appendectomy in humans, probably the world’s first report. Materials and Methods: Out of a total of 6 patients, a totally endoscopic transvaginal appendectomy was successfully performed for 1 patient. Pneumoperitoneum was achieved via a Veress needle in the umbilicus. Peritoneal access was gained via a transvaginal approach through the posterior fornix. Results: The other 5 patients were either converted to conventional laparoscopy or aided by a laparoscope. The average age of the patients was 29.5 years. The mean operating time was 103.5 minutes. Hospital stay was 1-2 days. The vaginal wound was examined by the gynecologist and found to have completely healed during the first and second follow up. Discussion: So far in humans, transgastric appendectomy and cholecystectomy, and transvaginal cholecystectomy have been reported. A transvaginal endoscopic appendectomy in humans has not been reported yet. The technical ease of the procedure and early outcome seem satisfactory, though comparative studies are needed to confirm this.
Program Number: P270