The German NOTES registry (GNR) is the largest published database for natural orifice transluminal endoscopic surgery (NOTES) worldwide.
Although transvaginal cholecystectomy is the most frequent procedure in the GNR, the number of colorectal resections is increasing.
Dr Dirk Bulian and colleagues analyzed the first 139 colonic procedures of the GNR.
All colonic procedures from the GNR were analyzed regarding patient- and therapy-related parameters.
A multivariate analysis was conducted for transvaginal sigmoid resections regarding procedural time, hospital stay, conversion rate, and rate of complications.
|Conversions to laparoscopic technique were necessary in about 4%|
|International Journal of Colorectal Disease|
From 2008 to 2013, 139 colon NOTES procedures were registered.
The research team's main diagnoses were sigmoid diverticulitis, colon carcinoma, and ulcerative colitis.
Sigmoid resections, proctocolectomies, right-sided resections, left-sided resections, segmental resections, and 1 ileocecal resection were performed.
the team performed all procedures in transvaginal or transrectal hybrid technique, with a median of 3 percutaneous trocars.
Conversions to laparoscopic technique were necessary in about 4%.
Intraoperative complications were recorded in 3% and postoperative complications in 12%.
The institutional case number in transvaginal sigmoid resections correlated negatively with procedural time, and the number of percutaneous trocars.
Dr Bulian's team concludes, "The analysis of the first 139 colon NOTES operations of the GNR shows the feasibility of colon operations in hybrid technique, especially for transvaginal sigmoid resection as the most frequent procedure."