BACKGROUND: Transvaginal video-assisted cholecystectomy with rigid instruments is a new procedure that combines natural orifice surgery (NOS) with classic laparoscopy. This hybrid technique requires conventional laparoscopy via an umbilical incision. To date it is unclear if this procedure is safe and feasible in routine practice. METHODS: We report on a case series of 128 women who consented to transvaginal cholecystectomy. Data, including visual analog scores (VAS), were collected prospectively via a standard digital spreadsheet. Patients completed satisfaction questionnaires within 10 days after discharge from hospital. We report on outcomes, age, body mass index, operating time, complications, pain scores, and patient satisfaction. RESULTS: In 115 (89.8%) patients the procedure was performed as a transvaginal operation. In 11 women (8.6%), we converted to standard laparoscopy, and in 2 cases (1.6%), we converted to an open procedure. Mean age was 52.4 years (range = 23-78 years) and mean body mass index was 27.8 (range = 18.8-42). Mean operating time was 60.6 min (range = 22-110 min). Other procedures were combined with hybrid cholecystectomy in six cases. Complications following transvaginal access included one vaginal bleeding, one perforation of the urinary bladder, and one superficial lesion of the rectum. In one case the hepatic duct had to be stented due to leakage after the procedure via endoscopic retrograde cholangiography. Mean VAS on day 1 was 2.26 (± 0.31 SEM) and on day 2 it was 1.53 (± 0.35 SEM). In a postoperative questionnaire, 95% of patients indicated that they would recommend this procedure to other patients. CONCLUSIONS: Transvaginal cholecystectomy is a safe and easy-to-learn procedure. Possible complications are different than those of standard laparoscopic procedures. Trauma to the abdominal wall and scarring is minimal. Postoperative pain scores were not different than those of standard laparoscopy and a high percentage of patients are satisfied with the procedure.
BACKGROUND: Transvaginal video-assisted cholecystectomy with rigid instruments is a new procedure that combines natural orifice surgery (NOS) with classic laparoscopy. This hybrid technique requires conventional laparoscopy via an umbilical incision. To date it is unclear if this procedure is safe and feasible in routine practice. METHODS: We report on a case series of 128 women who consented to transvaginal cholecystectomy. Data, including visual analog scores (VAS), were collected prospectively via a standard digital spreadsheet. Patients completed satisfaction questionnaires within 10 days after discharge from hospital. We report on outcomes, age, body mass index, operating time, complications, pain scores, and patient satisfaction. RESULTS: In 115 (89.8%) patients the procedure was performed as a transvaginal operation. In 11 women (8.6%), we converted to standard laparoscopy, and in 2 cases (1.6%), we converted to an open procedure. Mean age was 52.4 years (range = 23-78 years) and mean body mass index was 27.8 (range = 18.8-42). Mean operating time was 60.6 min (range = 22-110 min). Other procedures were combined with hybrid cholecystectomy in six cases. Complications following transvaginal access included one vaginal bleeding, one perforation of the urinary bladder, and one superficial lesion of the rectum. In one case the hepatic duct had to be stented due to leakage after the procedure via endoscopic retrograde cholangiography. Mean VAS on day 1 was 2.26 (± 0.31 SEM) and on day 2 it was 1.53 (± 0.35 SEM). In a postoperative questionnaire, 95% of patients indicated that they would recommend this procedure to other patients. CONCLUSIONS: Transvaginal cholecystectomy is a safe and easy-to-learn procedure. Possible complications are different than those of standard laparoscopic procedures. Trauma to the abdominal wall and scarring is minimal. Postoperative pain scores were not different than those of standard laparoscopy and a high percentage of patients are satisfied with the procedure.
Authors: A Cardoso Ramos; A Murakami; M Galvão Neto; M Santana Galvão; A C Souza Silva; E Gonzalo Canseco; Y Moyses Journal: Endoscopy Date: 2008-07 Impact factor: 10.093
Authors: Edward D Auyang; Byron F Santos; Daniel H Enter; Eric S Hungness; Nathaniel J Soper Journal: Surg Endosc Date: 2011-05-07 Impact factor: 4.584
Authors: Dietmar H Borchert; Matthias Federlein; Verena A Müller; Stefan Wagenpfeil; Robert M Eisele Journal: Surg Endosc Date: 2014-12-25 Impact factor: 4.584
Authors: Dirk Rolf Bulian; Linda Trump; Jürgen Knuth; Robert Siegel; Axel Sauerwald; Michael A Ströhlein; Markus Maria Heiss Journal: Surg Endosc Date: 2012-08-28 Impact factor: 4.584
Authors: Stephanie G Wood; Feng Dai; Susan Dabu-Bondoc; Hosni Mikhael; Nalini Vadivelu; Andrew Duffy; Kurt E Roberts Journal: Surg Endosc Date: 2014-10-08 Impact factor: 4.584
Authors: Dirk R Bulian; Linda Trump; Jürgen Knuth; Nicola Cerasani; Markus M Heiss Journal: Langenbecks Arch Surg Date: 2013-03-01 Impact factor: 3.445
Authors: Peter B van den Boezem; Simone Velthuis; Harm J Lourens; Rahul A K Samlal; Miguel A Cuesta; Colin Sietses Journal: J Gastrointest Surg Date: 2013-03-09 Impact factor: 3.452
Authors: Stephanie G Wood; Susan Dabu-Bondoc; Feng Dai; Hosni Mikhael; Nalini Vadivelu; Kurt E Roberts Journal: Surg Endosc Date: 2014-04 Impact factor: 4.584