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Appendicitis-II: Diagnostic Studies and Management

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Related Experiment Video

Updated: Jul 7, 2026

Laparoscopic Anatomical Right Anterior Sectionectomy with a Hepatic Pedicle-first Approach: Technical Details and Representative Case Illustration

Laparoscopic Anatomical Right Anterior Sectionectomy with a Hepatic Pedicle-first Approach: Technical Details and Representative Case Illustration

Published on: October 24, 2025

NOTES--case report of a unidirectional flexible appendectomy.

Joern Bernhardt¹, Bernd Gerber, Hans-Christof Schober

¹Department of Interdisciplinary Endoscopy, Medical Center Suedstadt Rostock, Rostock, Germany. joern.bernhardt@kliniksued-rostock.de

International Journal of Colorectal Disease

|February 8, 2008

Summary

Natural orifice transluminal endoscopic surgery (NOTES) enabled a trans-vaginal appendectomy in a human patient. This minimally invasive approach shows promise for reduced pain and faster recovery.

Related Experiment Videos

Last Updated: Jul 7, 2026

Laparoscopic Anatomical Right Anterior Sectionectomy with a Hepatic Pedicle-first Approach: Technical Details and Representative Case Illustration

Laparoscopic Anatomical Right Anterior Sectionectomy with a Hepatic Pedicle-first Approach: Technical Details and Representative Case Illustration

Published on: October 24, 2025

Area of Science:

Minimally invasive surgical techniques
Gastroenterology
Surgical innovation

Background:

Natural orifice transluminal endoscopic surgery (NOTES) utilizes natural orifices for abdominal access.
Potential benefits include reduced pain, shorter recovery, and fewer wound complications.
This study reports the first trans-vaginal appendectomy in a human subject.

Observation:

Trans-vaginal access was evaluated in animal models before human application.
A single-canal gastroscope was used for abdominal exploration and appendix localization.
Appendix ligation and resection were performed using an endoloop and scissors.

Findings:

The patient experienced mild abdominal soreness post-procedure but was otherwise well.
Early feeding was initiated on the same day as the surgery.
The specimen was successfully retrieved using endoscopic instruments.

Implications:

NOTES procedures are in early clinical development stages.
Further advancements in equipment and techniques are needed for wider adoption.
This case demonstrates the feasibility of trans-vaginal NOTES for appendectomy.