The Control Study And Evaluation Between Transvaginal Endoscopic Cholecystectomy And Traditional Cholecystectomy

Background:Nearly 20 years, laparoscopic surgery as a representative of the modern minimally invasive surgical technique realized revolutionary breakthrough on the surgical area, laparoscopic operations have less operation surgical trauma, postoperative recovered faster comparing with traditional operation method, but still exist incision infection,the risk of incision hernia, and the patient still exist certain scar on the abdominal wall. With the further development of minimally invasive technique and patient desires and requirements, Natural Orifice transluminal Endoscopic Surgery (NOTES) was proposed. The main methods are:We use a long, soft gastrointestinal endoscopy going into the body's natural orifice (such as oral, anal, vagina and urethra), and puncture hollow viscus (such as gastric, rectum and bladder wall, vaginal) into the surgical field area. The process was guided by endoscopy in the operation. NOTES achieve the aim of no scar, postoperative pain lighter, more beautiful effect in the area of minimally invasive area. Due to the high technique difficulties of NOTES, celiac infection, and punctured-hole fistula, many methods of NOTES is on the animals research and clinical stage of exploration. We repeated demonstration on the animals experiment and successfully completed in design and manufacture special devices of NOTES. After sufficient preparation, we successful achieved first transvaginal cystic resection by endoscopic in Asian in 2009, May 24. By now 32 cases were done.Objective:To investigate the feasibility, safety and superiority of transvagina endoscopic cholecystectomy and compare it with traditional laparoscopic cholecystectomy. Methods:32 patients with gall-bladder diseases were treated in transvagina endoscopic cholecystectomy, and other 56 patients with gall-bladder diseases were accepted traditional laparoscopic cholecystectomy. Compare the postoperative pain-span, anodyne doses, enterocinesia time, operation time, out-of-bed activity time, average hospitalization day, treatment cost between the two group patients.Result:All of the 32 patients were completed the transvaginal endoscopic cholecystectomy successfully. Compare to the traditional laparoscopic cholecystectomy, NOTES has many advantages, such as, less postoperative pain, smaller dose of anodyne, earlier of enterocinesia and out-of-bed activity, shorter of average hospitalization day, and cheaper of treatment cost. However the operation time of NOTES is a little bit longer. The volume of hemorrhage in operation between two groups has no significant difference.Conclusion:Transvaginal endoscopic cholecystectomy is feasible and safety. Comparing to traditional laparoscopic operation, it has obviously superiority. Accompanying those operation tools were improved gradually, transvaginal endoscopic cholecystectomy should be widely applied in good condition hospitals.