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Published in:

01-10-2010

Transvaginal video-assisted cholecystectomy in clinical practice

Authors: Matthias Federlein, Dietmar Borchert, Verena Müller, Yüksel Atas, Frauke Fritze, Jens Burghardt, Dirk Elling, Klaus Gellert

Published in: Surgical Endoscopy | Issue 10/2010

Abstract

Background

Transvaginal video-assisted cholecystectomy with rigid instruments is a new procedure that combines natural orifice surgery (NOS) with classic laparoscopy. This hybrid technique requires conventional laparoscopy via an umbilical incision. To date it is unclear if this procedure is safe and feasible in routine practice.

Methods

We report on a case series of 128 women who consented to transvaginal cholecystectomy. Data, including visual analog scores (VAS), were collected prospectively via a standard digital spreadsheet. Patients completed satisfaction questionnaires within 10 days after discharge from hospital. We report on outcomes, age, body mass index, operating time, complications, pain scores, and patient satisfaction.

Results

In 115 (89.8%) patients the procedure was performed as a transvaginal operation. In 11 women (8.6%), we converted to standard laparoscopy, and in 2 cases (1.6%), we converted to an open procedure. Mean age was 52.4 years (range = 23–78 years) and mean body mass index was 27.8 (range = 18.8–42). Mean operating time was 60.6 min (range = 22–110 min). Other procedures were combined with hybrid cholecystectomy in six cases. Complications following transvaginal access included one vaginal bleeding, one perforation of the urinary bladder, and one superficial lesion of the rectum. In one case the hepatic duct had to be stented due to leakage after the procedure via endoscopic retrograde cholangiography. Mean VAS on day 1 was 2.26 (±0.31 SEM) and on day 2 it was 1.53 (±0.35 SEM). In a postoperative questionnaire, 95% of patients indicated that they would recommend this procedure to other patients.

Conclusions

Transvaginal cholecystectomy is a safe and easy-to-learn procedure. Possible complications are different than those of standard laparoscopic procedures. Trauma to the abdominal wall and scarring is minimal. Postoperative pain scores were not different than those of standard laparoscopy and a high percentage of patients are satisfied with the procedure.

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Title: Transvaginal video-assisted cholecystectomy in clinical practice
Authors: Matthias Federlein
Dietmar Borchert
Verena Müller
Yüksel Atas
Frauke Fritze
Jens Burghardt
Dirk Elling
Klaus Gellert
Publication date: 01-10-2010
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 10/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-010-0983-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transvaginal video-assisted cholecystectomy in clinical practice

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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