Endoscopy 2010; 42(10): 875-878
DOI: 10.1055/s-0030-1255756
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

Establishing transvaginal NOTES for gynecological and surgical indications: benefits, limits, and patient experience

A.  Hackethal1 , J.  Sucke2 , F.  Oehmke1 , K.  Münstedt1 , W.  Padberg2 , H.-R.  Tinneberg1
  • 1Department of Gynaecology and Obstetrics, Justus-Liebig-University Giessen, Germany
  • 2Department of General Surgery, Justus-Liebig-University Giessen, Germany
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Publikationsverlauf

submitted 18 April 2010

accepted after revision 10 June 2010

Publikationsdatum:
30. September 2010 (online)

Gynecologists have been performing transvaginal surgery for over a century and consequently the transvaginal approach was advocated for establishing natural orifice transluminal endoscopic surgery (NOTES) in gynecological and surgical practice. From 2008 the NOTES alternative has been offered to selected patients. Transvaginal cholecystectomies were intended in 13 patients and completed in 12. Various additional procedures were performed. All surgical procedures and postoperative courses were uneventful. The mean operating time for transvaginal cholecystectomy only was 88.4 minutes (standard deviation [SD] 17.3). A questionnaire was posted to the patients after a mean follow-up of 8.5 months. Patients primarily chose transvaginal NOTES because of the lack of scarring. Vaginal sensation was not affected. Patients perceived transgastric, transvesical, and transrectal surgery to be less acceptable approaches. The feasibility of transvaginal NOTES was proven for different indications. Patients’ experiences and perceptions concerning transvaginal NOTES were excellent.

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A. HackethalMD 

Department of Gynaecology and Obstetrics
Justus-Liebig-University Giessen

Klinikstrasse 32
35392 Giessen
Germany

Fax: +49-641-9945139

eMail: andreas.hackethal@gyn.med.uni-giessen.de