Tian Yu, Wu Shuo-dong, Wang Dan-bo, Chen Ying-han
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Zhonghua Yi Xue Za Zhi. 2012 Aug 14;92(30):2148-50.
To establish the technique and methodology of appendectomy through transvaginal natural orifice transluminal endoscopic surgery(NOTES)under laparoscopy.
Three cases of chronic appendicitis were selected to receive laparoscopic transvaginal resection of appendixes with concurrent vaginal hysterectomies for uterine fibroids at Shengjing Hospital of China Medical University from November 2010 to November 2011. The procedure was performed by a multidisciplinary team composed of surgeons and gynecologists. The clinical data such as operative duration, bleeding volume, morbidity and stay duration were collected and analyzed.
Appendectomies were performed with the working laparoscopic tools inserted through vagina. The en bloc resection was removed transvaginally through laparoscope. It took 34, 23 and 26 minutes respectively to complete the appendectomies. And the blood loss volume was minimal. There were no postoperative complications. And the patients were discharged scar-free after 3 days.
Transvaginal appendectomy is both feasible and safe when performed by a multidisciplinary team. As an emerging innovation, natural orifice transluminal endoscopic surgery is mini-invasive, better tolerated and more respectful of esthetics.
建立腹腔镜下经阴道自然腔道内镜手术（NOTES）行阑尾切除术的技术与方法。
选取2010年11月至2011年11月在中国医科大学附属盛京医院就诊的3例慢性阑尾炎患者，同时因子宫肌瘤行腹腔镜经阴道阑尾切除术及全子宫切除术。手术由外科医生和妇科医生组成的多学科团队完成。收集并分析手术时间、出血量、发病率及住院时间等临床资料。
通过阴道插入腹腔镜工作器械完成阑尾切除。经腹腔镜经阴道整块切除标本。完成阑尾切除分别用时34、23和26分钟，出血量极少。术后无并发症。患者术后3天无瘢痕出院。
由多学科团队实施经阴道阑尾切除术可行且安全。作为一种新兴的创新技术，自然腔道内镜手术微创、耐受性好且更符合美学要求。
