University of California, San Diego, CA, USA.
Surg Endosc. 2010 Sep;24(9):2322. doi: 10.1007/s00464-010-0954-9. Epub 2010 Feb 23.
Natural orifice translumenal endoscopic surgery (NOTES) has the potential to decrease the burden of an operation on a patient. Limitations of the endoscopic platform require innovative solutions to provide retraction and create an operation comparable with the gold standard, laparoscopic cholecystectomy.
Four patients underwent transvaginal cholecystectomy. All procedures were performed under laparoscopic vision to ensure safety. The endoscope and a long articulating RealHand instrument were placed via a 15-mm vaginal trocar. A magnetic retraction system was used to retract the gallbladder safely. Laparoscopic clips were used to ligate the cystic duct and artery. All four gallbladders were successfully removed. No complications occurred. The mean operating time was 102 min.
All four procedures were completed without complications. The four patients all were discharged shortly after surgery and reported normal sexual activity without pain.
Transvaginal cholecystectomy can be completed safely using current technology. Further studies are needed to determine the safety of the procedure and to determine whether it confers any benefits other than cosmesis.
自然腔道内镜手术（NOTES）有可能减轻患者手术的负担。内镜平台的局限性需要创新的解决方案来提供牵引，并创建与金标准腹腔镜胆囊切除术相当的手术。
四名患者接受了经阴道胆囊切除术。所有手术均在腹腔镜视野下进行，以确保安全。内窥镜和长节段的 RealHand 器械通过 15 毫米的阴道穿刺器放置。使用磁性牵引系统安全地牵引胆囊。腹腔镜夹用于结扎胆囊管和动脉。所有四个胆囊均成功切除。无并发症发生。平均手术时间为 102 分钟。
所有四项手术均无并发症完成。四名患者均在手术后不久出院，并报告正常的性生活，无疼痛。
使用当前技术可以安全地完成经阴道胆囊切除术。需要进一步的研究来确定该手术的安全性，并确定它是否除了美容效果之外还带来任何其他益处。
