Abstract

Background: NOTES cholecystectomy is increasingly being performed. However, since it is very challenging to obtain the essential critical view of safety (CVS) with current endoscopic technology, safe NOTES cholecystectomy cannot be ensured. Although a hybrid procedure is not considered true NOTES, it might, by using 2 mm instruments aid acquiring CVS. Simultaneously it could avoid enlargement of the abdominal incision because the duct and artery can be clipped endoscopically and the gallbladder is removed through the stomach.

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