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  • 505
  • 2010-02-17

Transvaginal hybrid NOTES cholecystectomy using an internal retractor

Epublication WebSurg.com, Feb 2010;10(02). URL:
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Under general anesthesia with the patient supine in lithotomy position, a pelvic exam is performed. A first 5mm umbilical trocar is placed and an exploratory laparoscopy is performed to ascertain the feasibility of a NOTES cholecystectomy. The patient is then tilted in steep Trendelenburg. The posterior vaginal vault is carefully examined before gaining access to the peritoneal cavity. A linear cold blade scalpel incision is made in the cul-de-sac, well posterior in the fold between the uterosacral ligaments, 1cm below the uterine os.