Transvaginal Appendectomy: A Systematic Review

Abstract

Background. Natural orifice transluminal endoscopic surgery (NOTES) is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina. Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques. Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched. Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal. Main Outcome Measures. Patient selection criteria, surgical techniques, and results. Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes). Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days. Limitations. There are a limited number of comparative studies and an absence of randomized studies. Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary.

Natural orifice transluminal endoscopic surgery (NOTES) salpingectomy for ectopic pregnancy: a first series demonstrating how a new surgical technique can be applied in a low-resource setting

“…Whether patients have less postoperative pain needs to be further assessed in larger studies. A systematic review on vNOTES appendectomies reported a trend towards shorter hospitalisation, quicker recovery, less analgesic requirement and better cosmetic satisfaction [15]. A similar result can be expected for vNOTES salpingectomy.…”

Natural Orifice Translumenal Endoscopic Surgery: Review of Its Applications in Bariatric Procedures

“…NOTES has gained popularity during recent years for less complex procedures such as cholecystectomy and appendicectomy. This is supported by evidence that when performed by appropriately trained surgeons the results can be favourable to that of conventional laparoscopic technique [ 7 , 25 ].…”

Transjejunal Extraction of Gallbladder After Mini-Laparoscopic Cholecystectomy in Patients with Previous Roux-en-Y Gastric Bypass: A Small Case Series

“…7,8 In addition to cholecystectomy, the transvaginal route can be used for appendectomy, colorectal resection, nephrectomy, sleeve gastrectomy, liver surgery, or incisional hernia repair. [7][8][9][10][11] The transanal route is used only for colorectal resections, and the transgastric route is mainly limited to cholecystectomy and appendectomy. 7,8,12 Here, we described three NOTES cholecystectomies through the jejunum, and to the best of our knowledge the small bowel as an access point for NOTES approaches has not been reported yet.…”