Rapid communication: transvaginal single-port NOTES nephrectomy: initial laboratory experience
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Updated: Jul 13, 2026
Single Port Donor Nephrectomy
Published on: March 12, 2011
Ralph V Clayman1, Geoffrey N Box, Jose Benito A Abraham
1Department of Urology, Division of Gastroenterology, University of California, Irvine, Orange, California 92868, USA. rclayman@uci.edu
Background And Purpose:
Natural orifice translumenal endoscopic surgery (NOTES) using purpose-built equipment has never been applied to urologic surgery. Herein, we present our initial experience with a trans-vaginal single-port NOTES nephrectomy.
Methods And Results:
An acute experiment was performed in a female farm pig. A single 12-mm trocar was placed in the midline and the TransPort Multi-Lumen Operating Platform (USGI Medical, San Clemente, CA) was passed transvaginally. This flexible device has four working channels and can be locked into position, thereby creating a rigid multitasking platform that allows two-handed tissue manipulation. Dissection was performed using an endoscopic needle knife and a tissue grasper for retraction. Via the 12-mm port, the renal artery and vein were taken separately with a vascular EndoGIA and standard laparoscopic titanium clips, respectively. The kidney was placed in a 10-mm EndoPouch retriever and removed intact via the vagina. The total operative time was 300 minutes.
Conclusion:
Transvaginal NOTES nephrectomy can be accomplished in a porcine model. Additional testing on survival animals is necessary to validate this approach.
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