Introduction
Natural orifice transluminal endoscopic surgery (NOTES) or scarless surgery offers the potential for reduced comorbidities. Herein, we present the first NOTES transvaginal nephrectomy in human.
Methods
NOTES transvaginal nephrectomy in a 57-year-old woman. A multidisciplinary team carried out the procedure. Pneumoperitoneum was achieved using a transumbilical Veress needle. Transvaginal port was placed through a posterior colpotomy. A 5?mm port was used to control the safe placement of the transvaginal port. Using articulated instruments, the kidney was mobilized and the renal hilum controlled with an EndoGIA. The kidney was extracted through the vaginal incision.
Results
Visualization, renal dissection, hilar control and extraction were performed transvaginally. The 5?mm umbilical port was only used to control vaginal port placement and retraction of the colon during hilar stapling. No intra or postoperative complications occurred. Hospital stay was 23 hours.
Conclusion
NOTES transvaginal nephrectomy is technically feasible. Instrumentation is limited. Future study is needed to better define patient selection and advantages of this technique.
