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[MANOS: Transvaginal cholecystectomies: preliminary report]
Raúl Castro-Pérez1, Luís Ramón Acosta-González, Eduardo Dopico-Reyes
1Servicio de Cirugía General, Hospital Universitario Abel Santamaría Cuadrado, Facultad de Ciencias Médicas de Pinar del Río, Cuba. castro@princesa.pri.sld.cu
Objective:
To present the first transvaginal cholecystectomies performed in Cuba.
Methods:
This is a study involving 7 female patients. The ages of the patients varied from 33 to 62 years of age, with an average age of 47.7. All of them had symptomatic cholelithiasis performed between March 11, 2008 and May 7, 2008. The operation performed in each case was a transvaginal cholecystectomy assisted with minilaparoscopy.
Inclusion Criteria:
Females between 18 and 65 years old; diagnosis of disease which requires cholecystectomy. The exclusion criteria included ASA III and IV, morbidly obese patients (BMI > 35), venereal diseases, acute and chronic pelvic inflammatory diseases, virgins and pregnant patients. The operations were performed by general surgeons using rigid laparoscopic instruments. Studied: operating room time; analgesia required and post-operative complications.
Results:
The operating room time was between 61 and 86 min, with an average of 72.4 min. Patients required no analgesia during the post-operative period. They were discharged in less than 24h following surgery. We found no complications in follow-up visits for up to one month after surgery.
Conclusions:
Minilaparoscopic-assisted transvaginal cholecystectomy is a feasible and safe method for expert laparoscopic surgeons. This technique was, and could be, performed using rigid, currently available laparoscopic instruments. Minilaparoscopic- assisted natural orifice surgery (MANOS) could be an intermediate step between Laparoscopic surgery and NOTES.