[Endoscopic transvaginal cholecystectomy]

Abstract

Introduction: Transluminal endoscopic surgery through natural orifices (NOTES) allows intraperitoneal surgical procedures with minimal access to the abdominal wall. Currently it is not yet possible to perform these interventions without laparoscopic assistance, so these procedures are hybrids, fusion of minilaparoscopy and transluminal endoscopic surgery We present a prospective clinical series of patients undergoing surgery for gallstones, with hybrid NOTES transvaginal cholecystectomy with a nursing care plan adapted to this new approach.

Methods: Prospective clinical series of consecutive patients, nonrandomized, with transvaginal NOTES cholecystectomy. The surgery was performe with the assistance of two parietal entryports, one of umbilical 5 mm and 3 mm right upper quadrant of the abdomen. Analysis of nursing care plan with particular attention to safety of the procedure parameters and anxiety associated to the surgery

Results: There were no serious systemic complications. The main problem with this type of surgery is the fear of patients in relation to the new ways for a non-gynecological transvaginal procedures as ckolecystectomy and the risk of vaginal bleeding and urinary infection.

Discussion: Hybrid transvaginal cholecystectomy is a good surgical model of minimally invasive surgery. Its implementation is possible in groups with habit laparoscopic surgery, using standard instrumentation of endoscopy and laparoscopic surgery. The surgical team, doctors and nurses, must be well prepared for this new approach, because special and innovative cares are demanded.