Transvaginal Approach for Nongynecologic Intraperitoneal Procedures

Abstract

The minimally invasive surgery through natural orifices has revolutionized the laparoscopic surgery for abdominal procedures. The use of the vaginal approach is not new for gynecologists but it is a new concept for the non-gynecological laparoscopic surgeons. The use of this new approach has been used to perform some procedures and to extract specimens after a laparoscopic surgery, but we don’t know exactly the number of procedures performed until today. There are few papers with clinical experience and a lot of philosophical papers about NOTES. Our aim is to know how and how often we are using this new approach for non-gynecological abdominal minimally invasive procedures. With the revision of the PubMed publications we obtained a total of 268 articles, of which 125 were included in the analysis (46.64%). Cholecystectomy was the procedure more usually performed: there is a large clinical experience with a total of 2432 transvaginal cholecystectomies. Bariatric surgery, colectomy and appendectomy have been other surgical procedures with some clinical experience in the use of the transvaginal approach. Analyzing the publications on transvaginal approach, we observed that the use of the vaginal route for non-gynecological abdominal surgery was not anecdotal, with accumulative experience of more than 3000 patients reported in published studies. The use of the vaginal route has shown its safety, obtaining some additional benefits such as the aesthetic and the faster functional recovery. Dyspareunia, one of the most feared, has not been reported in studies as a concern to consider.