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Related Experiment Video

Updated: Jun 5, 2026

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

Transvaginal endoscopic appendectomy.

Eung Jin Shin¹, Gui Ae Jeong, Jun Chul Jung

¹Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Journal of the Korean Society of Coloproctology

|January 12, 2011

Summary

Natural orifice transluminal endoscopic surgery (NOTES) offers minimally invasive abdominal access. A transvaginal flexible endoscopic appendectomy with a small umbilical port demonstrates a safe and effective hybrid approach in humans.

Keywords:

Appendectomy Endoscopy Hybrid NOTES

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Area of Science:

Minimally Invasive Surgery
Gastroenterology
Surgical Innovation

Background:

Natural orifice transluminal endoscopic surgery (NOTES) has advanced from porcine models to human applications.
Various natural orifice access routes (transgastric, transvesical, transcolonic, transvaginal) have been explored for abdominal procedures.
Challenges in transgastric NOTES include infection risk, leakage, and gastric closure methods.

Observation:

Hybrid-NOTES, combining natural orifice access with minimal ports, is considered a practical initial step for human application.
Transvaginal access has a history of diagnostic and therapeutic use in human surgery.
A 74-year-old woman with acute appendicitis underwent a novel procedure.

Findings:

A transvaginal flexible endoscopic appendectomy was successfully performed.
The procedure utilized a 5-mm umbilical port and ultrasonic scissors.
This represents a hybrid approach combining transvaginal access with a small umbilical port.

Implications:

This case highlights the potential of hybrid NOTES for treating appendicitis in humans.
Transvaginal endoscopic appendectomy may offer a less invasive alternative to traditional surgery.
Further research into hybrid NOTES procedures could expand minimally invasive treatment options.