Safety of transvaginal hybrid NOTES cholecystectomy: a systematic review and meta-analysis

Sodergren, Mikael H.; Markar, Sheraz R.; Pucher, Philip H.; Badran, Ismail; Jiao, Long R.; Darzi, Ara

doi:10.1007/s00464-014-3915-x

Cited by 33 publications

(36 citation statements)

References 25 publications

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“…Another clear benefit of TVC is improved cosmesis. Importantly, there appears to be no significant difference in postoperative complications or rate of bile duct injury between TVC and CLC in these trials, conducted in centers of excellence and on selected patients [50] . Moreover, several studies reported no dyspareunia or difference in return to sexual activity between TVC and CLC groups after shortterm follow up [4749] .…”

Section: Natural Orifice Transluminal Endoscopic Cholecystectomymentioning

confidence: 89%

“…This technique is associated with longer operative time than CLC, and the conversion rate of TVC to CLC is estimated at 10% [47] . To date, three randomized control trials have been published, comparing transvaginal hybrid cholecystectomy to conventional [47,48] or needlescopic [49] laparoscopic cholecystectomy, along with one metaanalysis [50] . The proponents of NOTES cite reduced postoperative pain as an advantage of TVC over CLC.…”

Section: Natural Orifice Transluminal Endoscopic Cholecystectomymentioning

confidence: 99%

“…The proponents of NOTES cite reduced postoperative pain as an advantage of TVC over CLC. However, a recent metaanalysis showed a nonsignificant reduction in postoperative pain but a significant decrease in time for return to normal activities [50] . Another clear benefit of TVC is improved cosmesis.…”

Section: Natural Orifice Transluminal Endoscopic Cholecystectomymentioning

confidence: 99%

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New minimally invasive approaches for cholecystectomy: Review of literature

Gaillard

Tranchart

Laïnas

et al. 2015

WJGS

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Laparoscopic cholecystectomy is the most commonly performed abdominal intervention in Western countries. In an attempt to reduce the invasiveness of the procedure, surgeons have developed single-incision laparoscopic cholecystectomy (SILC), minilaparoscopic cholecystectomy (MLC) and natural orifice transluminal endoscopic surgery (NOTES). The aim of this review was to determine the role of these new minimally invasive approaches for elective laparoscopic cholecystectomy in the treatment of gallstone related disease. Current literature remains insufficient for the correct assessment of emerging techniques for laparoscopic cholecystectomy. None of these procedures has demonstrated clear benefits over conventional laparoscopic cholecystectomy. SILC cannot be currently recommended as it can be associated with an increased risk of bile duct injury and incisional hernia incidence. NOTES cholecystectomy is still experimental, although hybrid transvaginal cholecystectomy is gaining popularity in clinical practice. As it is standardized and almost identical to the standard laparoscopic technique, MLC could lead to limited benefits without exposing patients to increased postoperative complications, being therefore adoptable for routine elective cholecystectomy. Technical challenges of SILC and NOTES cholecystectomy could be addressed with the evolution of new surgical tools that need to catch up with the innovative minds of surgeons. Regardless the place of these approaches in the future, robotization may be necessary to impose them as standard treatment.

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Section: Natural Orifice Transluminal Endoscopic Cholecystectomymentioning

confidence: 89%

Section: Natural Orifice Transluminal Endoscopic Cholecystectomymentioning

confidence: 99%

Section: Natural Orifice Transluminal Endoscopic Cholecystectomymentioning

confidence: 99%

See 1 more Smart Citation

New minimally invasive approaches for cholecystectomy: Review of literature

Gaillard

Tranchart

Laïnas

et al. 2015

WJGS

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“…It has not been reported in any of the larger gynecologic case series or more contemporary NOTES trials. 15,17,20–22 Despite concerns regarding bacterial seeding of the abdominal cavity by opening a natural orifice, infection rates appear comparable to those of the transabdominal approach, and no strong evidence from bacteriological studies supports these fears. Impact on female sexual function is worthy of strong consideration.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Transvaginal NOTES and Mini-Laparoscopic Colectomy: Benefit Through Synergy

Moloney

Gan²

2016

JSLS

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Background and Objectives:Hybrid-natural orifice surgery combines the advantages of traditional transabdominal laparoscopic surgery, while limiting surgical trauma to the abdominal wall. Among various routes of intra-abdominal access, the transvaginal method is most appealing because of its utility and proven safety. We describe a series of 4 colonic resections performed with this approach, combined with minilaparoscopy and needlescopic approaches, and discuss the technical aspects, efficacy, and applicability of this technique.Methods:Three patients were selected to undergo hybrid transvaginal natural-orifice right hemicolectomy. A fourth patient, who underwent a segmental resection of a splenic flexure carcinoma, was included. Transvaginal port access was obtained via posterior colpotomy, and was used for dissection, vascular ligation, bowel division, and anastomosis. We used a combination of standard laparoscopic, minilaparoscopic, and needlescopic instruments transabdominally, focusing on reduced size and number of access points.Results:Duration of laparoscopy, oncologic outcomes and rate of operative morbidity were comparable to the published literature. Early return of gastrointestinal function and low analgesic requirements was observed in all patients. No morbidity related to transvaginal access was observed and the procedure was performed without difficulty in all cases.Conclusion:Colonic resection performed by hybrid natural-orifice technique offers several advantages over purely transabdominal laparoscopic procedures. Transvaginal access is easy to perform and offers excellent safety, efficacy, and versatility, especially for right hemicolectomy. Techniques to reduce abdominal wall surgical trauma, such as minilaparoscopy and needlescopic graspers, can be combined effectively in colonic resections, and may act synergistically to reduce postoperative pain and improve outcomes.

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“…Hauptvorteil von NOTES in geringeren postoperativen Schmerzen, einer rascheren Erholung, weniger Wundkomplikationen und Narbenhernien [2,14,18,22].…”

Section: Implementierung Der Hybrid-notes-sigmoidektomie Bei Divertikunclassified

Implementierung der Hybrid-NOTES-Sigmoidektomie bei Divertikelkrankheit

Steinemann

Zerz

Lamm

2016

Chirurg

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Safety of transvaginal hybrid NOTES cholecystectomy: a systematic review and meta-analysis

Abstract: TVC is safe when performed by appropriately trained surgeons and may be associated with a faster return to normal activities and decreased postoperative pain.

Cited by 33 publications

References 25 publications

New minimally invasive approaches for cholecystectomy: Review of literature

New minimally invasive approaches for cholecystectomy: Review of literature

Hybrid Transvaginal NOTES and Mini-Laparoscopic Colectomy: Benefit Through Synergy

Implementierung der Hybrid-NOTES-Sigmoidektomie bei Divertikelkrankheit

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