Decarli Luis, Zorron Ricardo, Branco Alcides, Lima Fernando Cirme, Tang Marcos, Pioneer Sergio Ricardo, Zanin Idilio, Schulte Alfredo Augusto, Bigolin André Vicente, Gagner Michel
Department of Surgery, Hospital Irmandade Santa Casa da Misericordia, Porto Alegre, Brazil.
Obes Surg. 2008 Jul;18(7):886-9. doi: 10.1007/s11695-008-9523-x. Epub 2008 May 14.
Transvaginal natural orifice translumenal endoscopic surgery (NOTES) is a new diagnostic and potentially therapeutic method of surgical endoscopy. The first case of NOTES transvaginal cholecystectomy in a morbid obese patient in the literature is described. IRB approval was obtained at the institution for transvaginal NOTES clinical trials. A 58-year-old female patient with cholelithiasis, hypertension, and type II diabetes, and BMI of 35.8 kg/m(2) was submitted to the technique. After transvaginal access, a two-channel gastroscope was introduced into the abdominal cavity along with a laparoscopic trocar. There were 2 umbilical punctures for use of 3 mm laparoscopic equipment. Operative time was 85 min. There was no use of postoperative analgesia, and the patient was discharged on the third postoperative day. Transvaginal NOTES is a feasible alternative method for cholecystectomy in the morbidly obese, although available technology is limited for natural orifice surgery.
经阴道自然腔道内镜手术（NOTES）是一种新型的手术内镜诊断及潜在治疗方法。本文描述了文献中首例针对病态肥胖患者的经阴道NOTES胆囊切除术。该机构已获得机构审查委员会（IRB）对经阴道NOTES临床试验的批准。一名58岁女性患者，患有胆结石、高血压和II型糖尿病，体重指数（BMI）为35.8kg/m²，接受了该技术治疗。经阴道进入后，将双通道胃镜与腹腔镜套管针一起引入腹腔。通过脐部穿刺两处，以便使用3mm腹腔镜设备。手术时间为85分钟。术后未使用镇痛药物，患者于术后第三天出院。经阴道NOTES对于病态肥胖患者的胆囊切除术是一种可行的替代方法，尽管目前自然腔道手术的可用技术有限。
