REVIEWS   

Chirurgia 2013 August;26(4):299-301

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Transvaginal cholecystectomy: technical aspects and future perspectives of NOTES surgery

Galloro G., Sivero L., D’antonio D., Benassai G., Quarto G., Luglio G., Bucci L., Formisano C.

Department of General, Geriatric Oncologic and Advanced Technologies Surgery Federico II University of Naples, Naples, Italy

Notes surgery (Natural Orifice Transluminal Endoscopic Surgery) is a novel approach for surgical treatment of abdominal diseases. It is based on the use of a flexible scope to enter the abdominal cavity (via transesophageal access, transgastric, transcolonic, transvaginal, or tranvescical). This approach is also based on the combination of modern endoscopic and laparoscopic procedures and technologies. One of the most known procedures is the transvaginal cholecystectomy (TVC): it is realised making a posterior colpotomy, in order to enter the abdominal cavity. Two types of TVC have been described: a “pure TVC” which is completely performed through the vagina, and a “hybrid TVC”, in which colpotomy represents only a visual support for the abdominal operation. Although TVC is now considered a very interesting approach both for surgeons and patients, its role is limited by the lack of a proper equipment and it might be impaired by a high rate organ injury due to instruments introduction; more, it is a very challenging procedure for surgeons. In this review we go through all the most recent techniques and modern equipment which are currently used to realize the TVC.