Ectopic Pregnancy

Natural orifice transluminal endoscopic surgery (NOTES) salpingectomy for ectopic pregnancy: a first series demonstrating how a new surgical technique can be applied in a low-resource setting | SpringerLink

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Gynecological SurgeryNovember 2015, Volume 12, Issue 4, pp 299–302Natural orifice transluminal endoscopic surgery (NOTES) salpingectomy for ectopic pregnancy: a first series demonstrating how a new surgical technique can be applied in a low-resource settingAuthorsAuthors and affiliationsVan Peer SarahBaekelandt JanEmail authorTechniques and InstrumentationFirst Online: 10 July 2015Received: 13 November 2014Accepted: 29 June 2015DOI: 10.1007/s10397-015-0904-6Cite this article as: Sarah, V.P. & Jan, B. Gynecol Surg (2015) 12: 299. doi:10.1007/s10397-015-0904-6 2 Citations 1 Shares 88 Downloads AbstractThis paper demonstrates the feasibility of a salpingectomy for ectopic pregnancy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES). Conventional, reusable laparoscopic instruments were used and inserted through an inexpensive, self-constructed single port device. The self-constructed single port device was made by assembling a surgical glove, a wound protector, one reusable 10-mm trocar and four reusable 5-mm trocars. We report on five patients who underwent a vNOTES salpingectomy between September 2014 and February 2015. All procedures were successfully performed, without conversion to multi-incision laparoscopy or laparotomy. This demonstrates that it is possible to perform a vNOTES salpingectomy without any financial investment in expensive ports, disposable instruments or sealing devices (Video 1). Patient and perioperative data were analysed (Table 1). NOTES salpingectomy is a novel technique requiring further validation. It could be a less invasive alternative to a laparoscopic salpingectomy. A better cosmetic result, by avoiding abdominal incision scars, and less port-related complications, can be expected.KeywordsTransvaginal natural orifice transluminal endoscopic surgery (NOTES)Single portFrugal innovationTubal pregnancySalpingectomyLow resourcevNOTESElectronic supplementary materialThe online version of this article (doi:10.1007/s10397-015-0904-6) contains supplementary material, which is available to authorized users.Supplementary materialView videoESM 1Video of NOTES salpingectomy for ectopic pregnancy (MP4 144,440 kb)References1.Nieboer TE, Johnson N, Lethaby A et al (2009) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev Issue 3. Art No: CD003677. doi:10.1002/14651858.CD003677.pub4 2.Yang YS, Oh KY, Hur MH, Kim SY, Yim HS (2015) Laparoendoscopic single-site surgery using conventional laparoscopic instruments and glove porttechnique in gynecology: a single surgeon’s experience. 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Reprod Biomed Online 4(Supple 3):72–75CrossRefPubMedGoogle Scholar12.Franz M, Ott J, Watrelot A et al (2015) Prospective evaluation of the learning curve of fertiloscopy with and without ovarian drilling. Reprod Biomed Online 30(4):408–414CrossRefPubMedGoogle Scholar13.Baekelandt J (2014) Poor man’s NOTES: can it be a good approach for adhesiolysis? A first case report with video demonstration. J Minim Invasive Gynecol Nov 10. doi:10.1016/j.jmig.2014.11.001 14.Santos BF, Hungness ES (2011) Natural orifice translumenal endoscopic surgery: progress in humans since white paper. World J Gastroenterol 17:1655–1665PubMedCentralCrossRefPubMedGoogle Scholar15.Yagci MA, Kayaalp C (2014) Transvaginal appendectomy: a systematic review. J Minim Invasive Surg 2014:384706. doi:10.1155/2014/384706 Google Scholar16.Zornig C, Mofid H, Siemssen L et al (2009) Transvaginal NOTES hybrid cholecystectomy: feasibility results in 68 cases with mid-term follow-up. Endoscopy 41:391–394CrossRefPubMedGoogle Scholar17.Lee CL, Wu KY, Su H, Wu PJ, Han CM, Yen CF (2014) Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (NOTES): a series of 137 patients. J Minim Invasive Gynecol 21(5):818–824CrossRefPubMedGoogle Scholar18.Tanaka M, Sagawa T, Yamazaki R, Myojo S, Dohi S, Inoue M (2013) Evaluation of transvaginal peritoneal surgery in young female patients. Surg Endosc 27:2619–2624CrossRefPubMedGoogle ScholarCopyright information© Springer-Verlag Berlin Heidelberg 2015Authors and AffiliationsVan Peer Sarah1Baekelandt Jan1Email author1.Department of Obstetrics and GynaecologyImelda Hospital BonheidenBonheidenBelgium About this article Print ISSN 1613-2076 Online ISSN 1613-2084 Publisher Name Springer Berlin Heidelberg About this journal Reprints and Permissions


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