Hybrid transvaginal and transumbilical laparoendoscopic adnexal surgery.

BACKGROUND

Natural orifice translumenal endoscopic surgery (NOTES) is an emerging concept in the recent literature that could lead to potential benefits in clinical applications. The present study describes the initial clinical application in 15 cases of hybrid transvaginal and transumbilical NOTES and discusses the feasibility, safety, and potential benefits of the method.

PATIENTS AND

METHODS

We evaluated the records of 15 patients who underwent hybrid transvaginal and transumbilical laparoendoscopic adnexal surgery between January 2010 and September 2011.

RESULTS

Procedures included salpingo-oophorectomy (n=7) and cystectomy (n=3) for ovarian tumors and salpingectomy (n=5) for unruptured tubal pregnancy. The mean operative time was 79 minutes (range, 49-116 minutes). Blood loss was minimal in all cases. All procedures were successfully performed, and there were no conversions to conventional multiport laparoscopy or open surgery. Gynecologic examination after 3 months showed no negative findings, and the cosmetic result was ideal with no visible scar.

CONCLUSIONS

Hybrid transvaginal and transumbilical NOTES is feasible and safe in select patients, and it provides no visible scar.