Transvaginal hybrid-NOTES vs. traditional laparoscopic sigmoid resection for diverticulitis: a short-term comparative...

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• Natural Orifice Transluminal Endoscopic Surgery (NOTES) offers reduced trauma by avoiding abdominal incisions.
• Transvaginal hybrid NOTES (NSR) for sigmoid resection is gaining traction but lacks comparative studies.
• Traditional laparoscopic sigmoid resection (LSR) is a standard treatment for diverticulitis.

Purpose of the Study:

• To compare the short-term outcomes of transvaginal hybrid NOTES (NSR) versus traditional laparoscopic sigmoid resection (LSR) for diverticulitis.
• To evaluate differences in postoperative pain, complications, and hospital stay between NSR and LSR.
• To determine if NSR is a viable alternative to LSR.

Main Methods:

• Retrospective comparison of 20 NSR patients with 20 matched LSR patients.
• Patients were matched for BMI, ASA classification, Hansen/Stock classification, and age.
• Key outcomes analyzed included procedural time, complications, pain, analgesic consumption, and hospital stay.

Main Results:

• No significant differences were found in pain levels, procedure duration, or complication rates between NSR and LSR.
• NSR demonstrated significantly lower morphine requirements on postoperative days seven and eight.
• NSR resulted in a significantly shorter postoperative length of hospital stay compared to LSR.

Conclusions:

• Transvaginal hybrid NOTES (NSR) is a safe and effective alternative to laparoscopic sigmoid resection (LSR) for diverticulitis.
• NSR offers advantages in reduced hospital stay and postoperative pain management (morphine consumption).
• Patient preference and surgeon experience are key considerations for choosing between NSR and LSR.