Transvaginal organ extraction: potential for broad clinical application

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Gynecologic Surgery

Background:

• Natural orifice transluminal endoscopic surgery (NOTES) is advancing.
• Transvaginal endoscopy offers a promising route for intraperitoneal procedures.
• Evaluating transvaginal organ extraction's safety and feasibility is crucial.

Purpose of the Study:

• To assess the safety and feasibility of transvaginal organ extraction.
• To evaluate outcomes for cholecystectomy, appendectomy, and sleeve gastrectomy via a transvaginal approach.

Main Methods:

• Retrospective review of an ongoing prospective study.
• Inclusion of female patients (18-75 years) undergoing elective cholecystectomy, appendectomy, or sleeve gastrectomy.
• Utilized a hybrid transvaginal natural orifice approach.

Main Results:

• 34 women underwent transvaginal organ extraction with no intraoperative complications or conversions to open surgery.
• Mean operative times were 90, 71, and 135 minutes for cholecystectomy, appendectomy, and sleeve gastrectomy, respectively.
• Mean hospital stay was 2 days; no long-term complications or mortalities were observed, with 18% experiencing minor postoperative vaginal spotting.

Conclusions:

• Transvaginal organ extraction appears safe and feasible, without increasing length of stay or causing long-term vaginal complications.
• This approach may be a superior method for organ extraction.
• Further randomized studies and long-term follow-up are warranted to confirm these findings.