Pure Natural Orifice Translumenal Endoscopic Surgery Management of Simple Renal Cysts: 2-Year Follow-Up Results

2011 ◽  
Vol 25 (1) ◽  
pp. 75-80 ◽  
Author(s):  
En-Chun Li ◽  
Jian-Quan Hou ◽  
Lin-Bin Yang ◽  
He-Xing Yuan ◽  
Li-Hua Hang ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Renal Cysts ◽  
Natural Orifice ◽  
Surgery Management

scholarly journals Repeat Vaginal Natural Orifice Transluminal Endoscopic Surgery: A First Feasibility Study

2021 ◽  
pp. 1-6
Author(s):  
Katrien Nulens ◽  
Ilse Van Genechten ◽  
Jan Baekelandt
Keyword(s):  
Peritoneal Cavity ◽  
Endoscopic Surgery ◽  
Large Scale ◽  
Case Series ◽  
Small Sample ◽  
Invasive Technique ◽  
Natural Orifice ◽  
Adnexal Surgery

<b><i>Objectives:</i></b> Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging minimally invasive technique in benign gynaecologic surgery whereby surgical access to the peritoneal cavity is achieved through natural orifices, namely through a vaginal colpotomy. Experience in repeat vNOTES cases is limited and so far, repeat vNOTES cases have not been described in the literature. The purpose of this study was to demonstrate the feasibility of vNOTES hysterectomy in women with a history of previous vNOTES adnexal surgery. <b><i>Design:</i></b> We performed a retrospective cohort study of the first 11 repeat vNOTES cases in our centre. All vNOTES procedures, primary adnexal surgery as well as repeat vNOTES hysterectomy, were performed by one surgeon (J.B.). <b><i>Materials, Setting, Methods:</i></b> Between March 2016 and May 2020, 11 patients underwent a vNOTES hysterectomy after prior vNOTES adnexectomy or cystectomy in Imelda Hospital, Bonheiden, Belgium. Relevant patient characteristics and outcome data were collected after written informed consent. <b><i>Results:</i></b> Median age was 49 years (range 44–65) at the moment of the first vNOTES procedure. Two patients had one or more caesarean sections in history, and 2 women were nulliparous. Median interval between primary and repeat vNOTES procedure was 15 months (range 0.8–37 months). All patients underwent a vaginally assisted NOTES hysterectomy (VANH) as repeat vNOTES procedure. Performing a colpotomy and entering the peritoneal cavity after prior vNOTES was technically feasible in all cases. All VANHs were successfully performed. There were 3 minor complications after repeat vNOTES, of which one was anaesthesia-related. The 2 complications associated with the surgical procedure were both cystitis. In one of these 2 patients, there were high post-void residues, which were easily managed by bladder training. There were no conversions to laparoscopy or laparotomy, neither serious nor life-threatening complications. No ureteric, bladder, or intestinal injuries have occurred. <b><i>Limitations:</i></b> The retrospective design and small sample size are the main limitations of this study. Moreover, the follow-up period of the most recently operated patients was too short to draw conclusions on long-term outcomes, including sexual function. <b><i>Conclusions:</i></b> In all patients in this case series, vNOTES hysterectomy after prior vNOTES adnexal surgery was successfully performed. Large-scale prospective trials with long-term follow-up are needed to evaluate the safety and feasibility of multiple consecutive vNOTES procedures in 1 patient.

scholarly journals Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Low-grade Endometrial Cancer: The First Fifty Patients

2021 ◽  
Author(s):  
alexander burnett ◽  
Martha Rojo
Keyword(s):  
Endometrial Cancer ◽  
Endoscopic Surgery ◽  
Frozen Section ◽  
Patient Characteristics ◽  
Low Grade ◽  
Natural Orifice ◽  
Study Objective ◽  
University Population ◽  
Node Removal

Study Objective: To review our experience with low-grade endometrial cancer managed with vaginal natural orifice transluminal endoscopic surgery (vNOTES) to determine the feasibility of this approach. Design: Retrospective review of the first fifty cases of endometrial cancer treated by vNOTES Setting: Academic University Population: Fifty consecutive cases of vNOTES management of women with low-grade endometrial cancer were reviewed to detail patient characteristics, operative procedures and outcomes, complications and follow-up. Methods: Patients underwent vNOTES hysterectomy and bilateral salpingo-oophorectomy. If Mayo criteria for lymphadenectomy were met, a laparoscopic lymph node removal was performed. Main Results: Mean age was 63 (33-90); mean BMI was 35.4 (22-58). In 44 women, both tubes and ovaries were removed via vNOTES. Three women had their ovaries retained due to early age, one woman had exploration for removal of an ovary with metastatic disease, and two women had neither tubes nor ovaries removed due to atresia and inability to identify these organs. Two patients underwent laparoscopic lymphadenectomy on the bases of frozen section evaluation. Mean operative time was 98 minutes (30-215). Fourteen patients were discharged the day of surgery; 34 discharged after overnight observation; hospitalization was prolonged in one patient due to ileus and one patient underwent laparotomy 30 hours after vNOTES for bleeding. Conclusion: VNOTES is a feasible management strategy for women with low-grade endometrial cancer. It permits laparoscopic inspection of the abdomen and direct visualization of vascular pedicles. It can provide a rapid recovery with minimal discomfort and no visible scar.

scholarly journals Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Uterosacral Ligament Suspension: a Pilot Study of 35 Caseswith Severe Pelvic Organ Prolapse

2021 ◽  
Author(s):  
Zhiying Lu ◽  
Yisong Chen ◽  
Xiaojuan Wang ◽  
Junwei Li ◽  
Keqin Hua ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Endoscopic Surgery ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Uterosacral Ligament Suspension ◽  
Natural Orifice ◽  
Short Term ◽  
Before And After ◽  
The Mean

Abstract Background To describe the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) in patients with severe prolapse.Methods This is a retrospective study conducted for patients with severe prolapsed (≥stage 3) who underwent vNOTES USLS between May 2019 and July 2020. The Pelvic Organ Prolapse Quantification (POP-Q) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and Pelvic Floor Inventory-20 (PFDI-20) were used to evaluate physical prolapse and quality of life before and after vNOTES USLS.Results A total of 35 patients were included. The mean operative time was 111.7±39.4 minutes. The mean blood loss was 67.9±35.8 ml. Statistically significant differences were observed before and after vNOTES USLS in regard to Aa (+0.6±1.7 versus −2.9±0.2), Ba (+1.9±2.2 versus −2.9±0.3), C (+1.5±2.2 versus -6.9±0.9), Ap (-1.4±1.0 versus −3.0±0.1) and Bp (-1.1±1.4 versus −2.9±0.1) (P < 0.05 for all). The mean pre- and post-operative PFDI-20 score was 19.9±6.7 versus 3.2±5.4, and the PISQ-12 score was 24.8±2.3 versus 38.3±4.1 (P < 0.05 for both). During 1–13 months of follow-up, no severe complications or recurrence.Conclusions vNOTES USLS may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety data. However, a study with a larger number of patients and a longer follow-up period should be conducted.

The mid-long-term follow up after transvaginal natural orifice transluminal endoscopic surgery in urology

2019 ◽  
Vol 18 (1) ◽  
pp. e1485
Author(s):  
X. Zou ◽  
G. Zhang ◽  
Y. Yuan ◽  
C. Lai ◽  
R. Xiao ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Natural Orifice ◽  
Long Term Follow Up

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

scholarly journals Open Versus Endoscopic Osteotomy of Posterosuperior Calcaneal Tuberosity for Haglund Syndrome: A Retrospective Cohort Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110010
Author(s):  
Yanbin Pi ◽  
Yuelin Hu ◽  
Qinwei Guo ◽  
Dong Jiang ◽  
Xin Xie ◽  
...  
Keyword(s):  
Cohort Study ◽  
Learning Curve ◽  
Endoscopic Surgery ◽  
Extent Of Resection ◽  
Endoscopic Procedure ◽  
Postoperative Outcomes ◽  
Open Procedure ◽  
Surgery Group ◽  
Duration Of Surgery

Background: Although endoscopic calcaneoplasty and retrocalcaneal debridement have been extensively applied to treat Haglund syndrome, evidence of the value of the endoscopic procedure remains to be fully established. Purpose/Hypothesis: The purpose of this study was to compare the postoperative outcomes and the amount of osteotomy between open and endoscopic surgery for the treatment of Haglund syndrome. It was hypothesized that endoscopic calcaneoplasty would lead to higher patient satisfaction and lower complication rates compared with open surgical techniques. Study Design: Cohort study; Level of evidence, 3. Methods: The following postoperative outcomes were compared between the open surgery group (n = 20) and the endoscopic surgery group (n = 27): visual analog scale for pain, American Orthopaedic Foot & Ankle Society ankle-hindfoot scale, Foot Function Index, Tegner score, Ankle Activity Score, and 36-Item Short Form Health Survey; postoperative complications; and duration of surgery. To determine the extent of resection, the authors compared the calcaneal height ratio, calcaneal resection ratio, calcaneal resection angle, pitch line, and Haglund deformity height between groups. The learning curve for endoscopic calcaneoplasty was also calculated. Results: There were no significant differences between the open and endoscopic groups on any outcome score. Two patients in the open group reported temporary paresthesia around the incisional site, indicating sural nerve injuries; no complication was reported in the endoscopy group. None of the parameters for extent of resection were statistically significant between the groups. The duration of surgery was 44.90 ± 10.52 and 65.39 ± 11.12 minutes in the open and endoscopy groups, respectively ( P = .001). Regarding the learning curve for endoscopic calcaneoplasty (6 surgeons; 27 follow-up patients; 9 patients lost to follow-up), the duration of surgery reached a steady point of 55.68 ± 4.19 minutes after the fourth operation. Conclusion: The results of this study indicated that the endoscopy procedure was as effective as the open procedure. The endoscopic procedure required significantly more time than the open procedure, and the duration of the endoscopic procedure was shortened only after the fourth operation, suggesting that it requires high technical skills and familiarity with the anatomic relationships.

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