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1.
van Gulik  TM Langenbuch's cholecystectomy, once a remarkably controversial operation.  Neth J Surg 1986;38 (5) 138- 141PubMedGoogle Scholar
2.
Reynolds  W The first laparoscopic cholecystectomy.  JSLS 2001;5 (1) 89- 94PubMedGoogle Scholar
3.
Mouret  P How I developed laparoscopic cholecystectomy.  Ann Acad Med Singapore 1996;25 (5) 744- 747PubMedGoogle Scholar
4.
National Institutes of Health Consensus Development Conference, Gallstones and laparoscopic cholecystectomy  NIH Consens Statement 1992;10 (3) 1- 28PubMedGoogle Scholar
5.
Reddy  NRao  P Per oral transgastric endoscopic appendectomy in human.  Paper presented at: 45th Annual Conference of the Society of Gastrointestinal Endoscopy of India February 28-29, 2004 Jaipur, India
6.
Kalloo  ANSingh  VKJagannath  SB  et al.  Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity.  Gastrointest Endosc 2004;60 (1) 114- 117PubMedGoogle Scholar
7.
Swanstrom  LLKozarek  RPasricha  PJ  et al.  Development of a new access device for transgastric surgery.  J Gastrointest Surg 2005;9 (8) 1129- 1137PubMedGoogle Scholar
8.
Park  POBergström  MIkeda  KFritscher-Ravens  ASwain  P Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis (videos).  Gastrointest Endosc 2005;61 (4) 601- 606PubMedGoogle Scholar
9.
Kantsevoy  SVJagannath  SBNiiyama  H  et al.  Endoscopic gastrojejunostomy with survival in a porcine model.  Gastrointest Endosc 2005;62 (2) 287- 292PubMedGoogle Scholar
10.
Kantsevoy  SVHu  BJagannath  SB  et al.  Transgastric endoscopic splenectomy: is it possible [published online ahead of print January 21, 2006]?  Surg Endosc 2006;20 (3) 522- 525PubMedGoogle Scholar
11.
Jagannath  SBKantsevoy  SVVaughn  CA  et al.  Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model.  Gastrointest Endosc 2005;61 (3) 449- 453PubMedGoogle Scholar
12.
Fong  DGPai  RDThompson  CC Transcolonic endoscopic abdominal exploration: a NOTES survival study in a porcine model.  Gastrointest Endosc 2007;65 (2) 312- 318PubMedGoogle Scholar
13.
Rolanda  CLima  EPego  JM  et al.  Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video).  Gastrointest Endosc 2007;65 (1) 111- 117PubMedGoogle Scholar
14.
Ghezzi  FRaio  LMueller  MDGyr  TButtarelli  MFranchi  M Vaginal extraction of pelvic masses following operative laparoscopy [published online ahead of print July 20, 2002].  Surg Endosc 2002;16 (12) 1691- 169610.1007/s00464-002-9043-zPubMedGoogle Scholar
Original Article
September 1, 2007

Surgery Without Scars: Report of Transluminal Cholecystectomy in a Human Being

Author Affiliations

Author Affiliations: Institut de Recherche contre les Cancers de l[[rsquo]]Appareil Digestif[[ndash]]European Institute of TeleSurgery, University Louis Pasteur, Strasbourg, France.

Arch Surg. 2007;142(9):823-826. doi:10.1001/archsurg.142.9.823
Abstract

Hypothesis  Natural orifice transluminal endoscopic surgery (NOTES) provides the potential for performance of incisionless operations. This would break the physical barrier between bodily trauma and surgery, representing an epical revolution in surgery. Our group at IRCAD-EITS (Institut de Recherche contre les Cancers de l’Appareil Digestif [Institute of Digestive Cancer Research]–European Institute of TeleSurgery) has been actively involved in the development of NOTES since 2004 with a dedicated project created to develop feasibility and survival studies and new endoscopic technology.

Design  NOTES cholecystectomy in a woman via a transvaginal approach.

Setting  University hospital.

Patient  The patient was a 30-year-old woman with symptomatic cholelithiasis.

Intervention  The procedure was carried out by a multidisciplinary team using a standard double-channel flexible videogastroscope and standard endoscopic instruments. The placement of a 2-mm needle port, mandatory to insufflate carbon dioxide and to monitor the pneumoperitoneum, was helpful for further retraction of the gallbladder. At no stage of the procedure was there need for laparoscopic assistance. All of the principles of cholecystectomy were strictly adhered to.

Results  The postoperative course was uneventful. The patient had no postoperative pain and no scars, and was discharged on the second postoperative day.

Conclusions  Transluminal surgery is feasible and safe. NOTES, a radical shift in the practice and philosophy of interventional treatment, is becoming established and is enormously advantageous to the patient. With its invisible mending and tremendous potential, NOTES might be the next surgical evolution.

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