Simultaneously with Vaginal Hysterectomy: Initial Experience of 10 Cases

Source of support: Departmental sources Background: Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material/Methods: We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparoscopic appen-dectomy simultaneously with vaginal hysterectomy. A laparoscopic approach was established after removal of the uterus, and the appendix was removed transvaginally. Among the 10 cases, 5 were conducted under gasless laparoscopy by using a simple abdominal wall-lifting instrument. Results: All procedures were performed successfully without intraoperative or major postoperative complications. The appendectomy portion of the procedure took approximately 21 minutes to 34 minutes. All patients were dis-charged less than 4 days after surgery, without external scars. Conclusions: Transvaginal appendectomy with rigid laparoscopic instruments following vaginal hysterectomy appears to b