Transvaginal laparoscopic right colectomy for colon neoplasia.

Abstract

The laparoscopic technique has been used for colorectal surgery for decades. Minimally invasive surgery is executed differently in operations on the right colon, left colon, and the rectum [1]. Sometimes, the abdominal incision is critical for rectal surgery, which can be used for extraction of the resected specimen and for creation of the diverting stoma. However, for right or left colectomy, once the anastomosis is performed intra-corporeally, then the specimen can be extracted through any incision (abdominal wall or vaginal) to enhance post-operative recovery. The natural-orifice transluminal endoscopic surgery (NOTES) approach has been used in operations on the colon and rectum to minimize abdominal trauma, as, for example, in transanal total mesorectal excision (taTME) [2], laparoscopic colectomies with transanal [3] or transvaginal specimen extraction [4]. Up to now, transabdominal assistant with the laparoscopic technique is critical for accomplishing colorectal NOTES operations, so it is called the hybrid NOTES technique [5, 6]. Pure NOTES has not been reported for colonic resection. Recently, we successfully performed a laparoscopic right colectomy via the transvaginal approach. Here we describe the procedure.