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Laparoscopic-Assisted Transvaginal Cholecystectomy - the US Military Experience With Long-Term Follow Up
Carolyn Judge1,2, Jesse Bandle1,2, Andrew Wang1,2
1Department of General Surgery, Naval Medical Readiness and Training Command, San Diego, California, USA. (Drs Judge, Bandle, Gadbois, and Wisbach).
Summary
Transvaginal cholecystectomy (TVC) using the Natural Orifice Transluminal Endoscopic Surgical (NOTES) technique is safe and effective for women. This minimally invasive approach may enhance recovery times for military personnel.
Area of Science:
- Minimally Invasive Surgery
- Surgical Innovation
- Gastrointestinal Surgery
Background:
- Natural Orifice Transluminal Endoscopic Surgery (NOTES) offers a less invasive alternative to traditional laparoscopic procedures.
- Evaluating the feasibility and outcomes of transvaginal cholecystectomy (TVC) is crucial for advancing surgical techniques.
Observation:
- Ten female patients underwent laparoscopic-assisted transvaginal cholecystectomy (TVC).
- The procedure involved a posterior colpotomy for a single-site working port and specimen retrieval through the vagina.
- Long-term follow-up assessed quality of life using RAND-36 and Female Sexual Function Index (FSFI) surveys.
Findings:
- TVC demonstrated a mean operative time of 129 minutes and a median blood loss of 34 ml.
- Patients experienced minimal postoperative pain, a short hospital stay (average 9.98 hours), and rapid return to daily activities.
- One case of postoperative urinary retention and one asymptomatic incisional hernia were the main complications.
Implications:
- Transvaginal cholecystectomy (TVC) is a safe and effective surgical option.
- This technique may improve operational readiness by expediting recovery compared to conventional laparoscopy.
- Further research into NOTES procedures can refine minimally invasive surgical standards.
