Weltweit erste Erfahrungen mit NOTES in der Gynäkologie

PURPOSE: The latest development in the field of minimal invasive surgery is NOTES (Natural Orifice Transluminal Endoscopic Surgery), in which an endoscopic access through the gastrointestinal tract or the vagina is used. In contrast to classical laparoscopic surgery, this technique allows surgery to be performed without visible scars. Cholecystectomy and appendectomy procedures have already been successfully performed with this technique, but it has not yet been employed in the field of surgical gynaecology. This study examines whether this new technique can also be used in gynaecological surgery. MATERIAL AND METHODS: A flexible endoscope (Storz) was inserted intraperitoneally using a transvaginal approach. Via the integrated working canals, it was possible to perform both an adnexectomy and a hysterectomy. To date, NOTES has been used in two female patients at the I. Gynaecological Hospital of the LMU Munich. RESULTS: The surgical technique and the postoperative outcomes of the patients are presented. CONCLUSION: The NOTES technique is a new and promising development in minimally invasive surgery, which can reduce invasiveness even further compared to classical laparoscopic surgery. Its use in a bigger collective of patients will demonstrate the value of this method in the field of gynaecological surgery.