• Yu Tian, Shuo-dong Wu, Dan-bo Wang, and Ying-han Chen.
• Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China.
• Zhonghua Yi Xue Za Zhi. 2012 Aug 14; 92 (30): 2148-50.

ObjectiveTo establish the technique and methodology of appendectomy through transvaginal natural orifice transluminal endoscopic surgery(NOTES)under laparoscopy.MethodsThree cases of chronic appendicitis were selected to receive laparoscopic transvaginal resection of appendixes with concurrent vaginal hysterectomies for uterine fibroids at Shengjing Hospital of China Medical University from November 2010 to November 2011. The procedure was performed by a multidisciplinary team composed of surgeons and gynecologists. The clinical data such as operative duration, bleeding volume, morbidity and stay duration were collected and analyzed.ResultsAppendectomies were performed with the working laparoscopic tools inserted through vagina. The en bloc resection was removed transvaginally through laparoscope. It took 34, 23 and 26 minutes respectively to complete the appendectomies. And the blood loss volume was minimal. There were no postoperative complications. And the patients were discharged scar-free after 3 days.ConclusionsTransvaginal appendectomy is both feasible and safe when performed by a multidisciplinary team. As an emerging innovation, natural orifice transluminal endoscopic surgery is mini-invasive, better tolerated and more respectful of esthetics.

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