NOTES: transvaginal for cancer diagnostic staging: preliminary clinical application

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Gynecologic Oncology

Background:

• Laparoscopy is a standard for gastrointestinal cancer staging, guiding therapy and preventing unnecessary laparotomies.
• Natural Orifice Transluminal Endoscopic Surgery (NOTES) presents potential benefits for patient recovery.
• Transvaginal NOTES is an emerging technique for minimally invasive procedures.

Observation:

• A 50-year-old female with ascites, abdominal pain, and weight loss was suspected of having peritoneal carcinomatosis.
• A computed tomography (CT) scan confirmed the suspicion of peritoneal carcinomatosis.
• The patient underwent a transvaginal NOTES procedure for diagnostic cancer staging.

Findings:

• A colonoscope was inserted transvaginally into the abdomen to perform biopsies.
• Biopsies of the liver, diaphragm, ovaries, and peritoneum were successfully obtained.
• All 16 biopsies confirmed ovarian adenocarcinoma; the patient recovered without complications within 48 hours.

Implications:

• Transvaginal NOTES can be a reliable diagnostic tool for staging gastrointestinal cancers.
• This technique may offer advantages in patient recovery compared to traditional laparoscopy.
• Further clinical applications of transvaginal NOTES for diagnostic purposes are suggested by preliminary findings.