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Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) for adnexal tumors
Myong Cheol Lim1, Tae-Joong Kim, Sokbom Kang
1Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
Background:
Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) has shown promise as a minimally invasive laparoscopic surgery technique.
Objective:
To investigate the feasibility and surgical outcome of E-NOTES for adnexal tumors.
Methods:
We performed E-NOTES in 12 patients with adnexal tumors through a 2-cm intraumblical incision. A single-port access system comprising a wound protractor and a surgical glove was used. A prospective data registry was used in this study.
Results:
Since 1 July 2008, 12 patients have undergone E-NOTES for adnexal tumors. E-NOTES in all 12 cases was completed successfully without conversion to standard laparoscopic approach. Median operative time for creating an E-NOTES access system and the ensuing operative procedures was 6 min (range 5-15 min) and 73 min (range 25-110 min), respectively. Median blood loss was <10 ml. No complications requiring treatment occurred.
Conclusion:
E-NOTES is a feasible alternative method for resection of adnexal tumors with better cosmetic outcome. More experience and instrumental improvement suitable for E-NOTES are needed.
