Notes: video assisted trans-vaginal cholecystectomy with conventional laparoscopic instruments: A description of surgical technique

Abstract

The access to perform a cholecystectomy has changed dramatically in the last 20 years, from open surgery to minimal invasive surgery such as laparoscopy and now since 2007, starting to perform through natural orifices. In the absence of ideals instruments, it could be possible to create safes access through transvaginal way with regular laparoscopic instruments in well selected patients. Objective: Describe a new surgical technique to perform a trans-vaginal cholecystectomy video assisted, with common laparoscopic instruments. Method: Technical description: With the patient under general anesthesia, placed her in gynecological position, we get access to the abdominal cavity through umbilicus, inserting a 10mm trocar, them under direct vision we perform the trans-vaginal access inserting one grasping forceps and 30º scope. The vaginal grasping forceps will hold the gallbladder between the fundus and the infundibulus, exposing the Calot triangle. Through the umbilicus trocar the surgeon dissect de cystic duct and artery, them it will be separated from its bed. The gallbladder is taking outside
from the abdomen through vaginal way. Conclusion: The trans-vaginal access is a feasibly way to perform cholecystectomy with common laparoscopic instruments. It is indispensable to dominate basic laparoscopic techniques, and before start practicing this procedure, it has to perform under animal’s models.