This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on ISI (11)  • Contact me when this article is cited  Related Content  • Related letters  • Related articles  • Similar articles in this journal  Topic Collections  • Endoscopy/ Minimally Invasive Surgery  • Hepatobiliary Surgery  • Alert me on articles by topic

Report of Transluminal Cholecystectomy in a Human Being

Jacques Marescaux, MD, FRCS; Bernard Dallemagne, MD; Silvana Perretta, MD; Arnaud Wattiez, MD; Didier Mutter, MD, PhD; Dimitri Coumaros, MD

Arch Surg. 2007;142(9):823-826.

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.

Author Affiliations: Institut de Recherche contre les Cancers de l’Appareil Digestif–European Institute of TeleSurgery, University Louis Pasteur, Strasbourg, France.

RELATED LETTERS

Is Natural Orifice Transluminal Endoscopic Cholecystectomy as Safe as Laparoscopic Cholecystectomy?
Robert C. Hall
Arch Surg. 2008;143(6):604.
EXTRACT | FULL TEXT  

Is Natural Orifice Transluminal Endoscopic Cholecystectomy as Safe as Laparoscopic Cholecystectomy?—Reply
Jacques Marescaux, Bernard Dallemagne, Silvana Perretta, Arnaud Wattiez, Didier Mutter, and Dimitri Coumaros
Arch Surg. 2008;143(6):604-605.
EXTRACT | FULL TEXT  

RELATED ARTICLES

Natural Orifice Transluminal Endoscopic Surgery
Jo Buyske
JAMA. 2007;298(13):1560-1561.
EXTRACT | FULL TEXT  

Surgery Without Scars—Invited Critique
John G. Hunter
Arch Surg. 2007;142(9):826-827.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Transumbilical Endoscopic Cholecystectomy With the Trichannel Trocar Technique: A Porcine Feasibility Study
Jiang Fan Zhu et al.
SURG INNOV 2008;15:95-99.
ABSTRACT  

Is Natural Orifice Transluminal Endoscopic Cholecystectomy as Safe as Laparoscopic Cholecystectomy?
Hall
Arch Surg 2008;143:604-604.
FULL TEXT  

Natural Orifice Transluminal Endoscopic Surgery: Lessons Learned From the Laparoscopic Revolution
Allori et al.
Arch Surg 2008;143:333-334.
FULL TEXT  

Natural Orifice Transluminal Endoscopic Surgery
Buyske
JAMA 2007;298:1560-1561.
FULL TEXT