Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience

Zou, Xin; Zhang, Guoxi; Xiao, Ran; Yuan, Yuanhu; Wu, Gengqing; Wang, Xiaoning; Long, Dazhi; Wu, Yuting; Liu, Min; Xue, Yu; Zhang, Xu

doi:10.1007/s00464-011-1786-y

Cited by 32 publications

(15 citation statements)

References 17 publications

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“…Their conclusion was that the transvaginal approach does not have a negative effect on female sexual function [11]. Zou et al [12] analysed female sexual function in 11 cases of transvaginal approach of adrenalectomy, and there was no difference between pre-and postoperative median FSFI total scores (p = 0.102). In a recent prospective cohort study of 106 women treated by a transvaginal approach for cholecystectomy (85) and anterior resection (21), 75 % of patients answered the FSFI questionnaire and had a mean total score of 28.1 exceeding the cut-off for sexual dysfunction defined as 26 [13].…”

Section: Discussionmentioning

confidence: 95%

Perioperative outcome and female sexual function after laparoscopic transvaginal NOTES-assisted nephrectomy

et al. 2015

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Section: Discussionmentioning

confidence: 95%

Perioperative outcome and female sexual function after laparoscopic transvaginal NOTES-assisted nephrectomy

et al. 2015

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“…In some articles the flexible endoscope was used, assessing a better vision than with rigid laparoscope, probably because the organs to be treated were in the supramesocolic space. In this situation, the flexible endoscope offered a better access with closer lighting and better access due to their mobility [124]- [134].…”

Section: Resultsmentioning

confidence: 99%

Transvaginal Approach for Nongynecologic Intraperitoneal Procedures

Noguera¹,

Martı́n²,

Muñoz³

et al. 2014

IJCM

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The minimally invasive surgery through natural orifices has revolutionized the laparoscopic surgery for abdominal procedures. The use of the vaginal approach is not new for gynecologists but it is a new concept for the non-gynecological laparoscopic surgeons. The use of this new approach has been used to perform some procedures and to extract specimens after a laparoscopic surgery, but we don't know exactly the number of procedures performed until today. There are few papers with clinical experience and a lot of philosophical papers about NOTES. Our aim is to know how and how often we are using this new approach for non-gynecological abdominal minimally invasive procedures. With the revision of the PubMed publications we obtained a total of 268 articles, of which 125 were included in the analysis (46.64%). Cholecystectomy was the procedure more usually performed: there is a large clinical experience with a total of 2432 transvaginal cholecystectomies. Bariatric surgery, colectomy and appendectomy have been other surgical procedures with some clinical experience in the use of the transvaginal approach. Analyzing the publications on transvaginal approach, we observed that the use of the vaginal route for non-gynecological abdominal surgery was not anecdotal, with accumulative experience of more than 3000 patients reported in published studies. The use of the vaginal route has shown its safety, obtaining some additional benefits such as the aesthetic and the faster functional recovery. Dyspareunia, one of the most feared, has not been reported in studies as a concern to consider.

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“…In addition, we also performed 11 even more challenging transvaginal NOTES adrenalectomies with promising results [28]. In these two studies, the renal and adrenal specimens were all removed through the vagina, which led to good cosmetic outcomes and no dyspareunia.…”

Section: Discussionmentioning

confidence: 99%

Transumbilical Multiport Laparoscopic Nephrectomy with Specimen Extraction through the Vagina

Zou

Zhang²,

Xue³

et al. 2014

Urol Int

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Objectives: To report our initial experience with transumbilical multiport laparoscopic nephrectomy (TMLN) with transvaginal specimen extraction. Patients and Methods: Between January and July 2010, 5 married and parous female patients were submitted to TMLN with transvaginal specimen extraction in our center. All data referring to patient demographics, surgery, pathology and perioperative outcomes were recorded. Sexual function was assessed with the Female Sexual Function Index questionnaire before and after surgery. The cosmetic result was investigated by administering the Patient Scar Assessment Questionnaire and Scoring System (PSAQ). Results: All procedures were completed successfully. The mean operative time was 136 min (range 110-160 min, standard deviation [SD] 20.7). The mean estimated blood loss was 66 ml (range 40-100 ml, SD 24.1). The mean postoperative hospitalization stay was 4.8 days (range 4-6 days, SD 0.8). All patients reported unaltered sexual function after surgery. The better cosmetic results were confirmed by the PSAQ score. Conclusions: TMLN with transvaginal specimen extraction is feasible and safe for married and parous female patients. This technique is a natural evolution towards natural orifice transluminal endoscopic surgery (NOTES). By acting as an intermediate-type procedure, it provides a bridge through which NOTES may ultimately gain clinical acceptance.

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Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience

Abstract: The findings show TNLA to be a feasible and effective surgical technique that results in excellent cosmesis. It may be an alternative technique for the treatment of properly selected female patients with adrenal tumor.

Cited by 32 publications

References 17 publications

Perioperative outcome and female sexual function after laparoscopic transvaginal NOTES-assisted nephrectomy

Perioperative outcome and female sexual function after laparoscopic transvaginal NOTES-assisted nephrectomy

Transvaginal Approach for Nongynecologic Intraperitoneal Procedures

Transumbilical Multiport Laparoscopic Nephrectomy with Specimen Extraction through the Vagina

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