Video. Repeated transvaginal notes: is it possible?

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Gynecologic Surgery

Background:

• Transvaginal (TV) surgery is a well-established gynecologic procedure.
• Natural Orifice Transluminal Endoscopic Surgery (NOTES) has expanded to extrapelvic disease via the TV route.
• Repeated TV access for NOTES has not been previously documented.

Observation:

• Two women underwent transvaginal hybrid sleeve gastrectomy followed by transvaginal cholecystectomy.
• The procedures were performed using a double-channel endoscope and laparoscopic assistance.
• Follow-up included pelvic examinations and sexual function assessment.

Findings:

• Both repeated TV access procedures were successful without intraoperative or postoperative complications.
• Minimal pelvic adhesions and no vaginal scarring were noted at the colpotomy site.
• Patients reported normal sexual function post-recovery.

Implications:

• Repeated transvaginal access for NOTES extrapelvic surgery is safe and feasible in experienced hands.
• This approach may lead to reduced adhesion formation compared to traditional laparoscopic surgery.
• It offers a potentially less invasive option for patients requiring multiple abdominal procedures.