Author's personal copy Laparoscopic assisted transvaginal cholecystectomy: Single centre preliminary experience Antonio Brescia*, Luigi Masoni, Marcello Gasparrini, Giuseppe Nigri, Umile Michele Cosenza, Anna Dall’Oglio, Alessandra Pancaldi, Francesco Saverio Mari Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea Hospital, School of Medicine and Psychology, University Sapienza of Rome, Rome, Italy article info Article history: Received 7 September 2012 Accepted 27 September 2012 Available online 23 November 2012 Keywords: Natural Orifice Transluminal Endoscopic Surgery Laparoscopic assisted transvaginal cholecystectomy Transvaginal cholecystectomy abstract Background: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a new approach that allows abdominal surgery to be performed through a natural orifice such as the oral cavity, vagina or rectum. We present our preliminary experience of laparoscopic assisted transvaginal cholecystectomy (LATC). Methods: Women affected by cholelithiasis, age below 65 years, BMI under 30, ASA I or II, previous full-term pregnancies, and without previous abdominal surgery underwent LATC. Patients’ biographic data, operative time, intraoperative and postoperative complications were collected. Results: We performed 21 LATCs. Median operative time was 58 min. There were no intraoperative complications. The postoperative course was uneventful in all patients. At 1 year there were no complications and no impaired sexual activity. Conclusions: The results of NOTES are promising, but currently only hybrid NOTES can be safely performed. LATC seems to guarantee better cosmetic results, less postoperative pain, faster mobilization and shorter hospitalization than laparoscopic cholecystectomy. ª 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. Introduction Laparoscopic surgery developed in the last decade of the 20th century gaining rapid acceptance and success as a new surgical approach. It allowed surgeons to minimize the incisions with major benefits to the patient in terms of reduced postoperative pain, increased postoperative comfort, reduced hospital stay, quicker return to normal physical activities and ultimately a faster return to work. While surgery has become less invasive, flexible endoscopy became the procedure of choice for diagnosis and treatment of many gastrointestinal diseases. The combination of minimally invasive surgical techniques and advanced ther- apeutic endoscopy led to the development of a new surgical approach that allows entry to the peritoneum or retro- peritoneum through natural body openings without skin incisions. This new surgical strategy, called Natural Orifice Transluminal Endoscopic Surgery (NOTES), offers enormous opportunities and represents a noteworthy surgical innovation. 1e4 We present our preliminary experi- ence of laparoscopic assisted transvaginal cholecystectomy (LATC). * Corresponding author. St. Andrea Hospital, Department of Surgery, One-Day Surgery, Via di Grottarossa 1035, 00189 Rome, Italy. Tel.: þ39 (0)633776020; fax: þ39 (0)633775065. E-mail addresses: onedaysurgery-info@yahoo.it (A. Brescia), frasavmari@yahoo.it (F.S. Mari). Available online at www.sciencedirect.com The Surgeon, Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland www.thesurgeon.net the surgeon 11 (2013) S1 eS5 1479-666X/$ e see front matter ª 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.surge.2012.09.003