Endoscopy 2007; 39(10): 913-915
DOI: 10.1055/s-2007-966911
Case report

© Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic cholecystectomy without visible scar: combined transvaginal and transumbilical approach

C.  Zornig1 , A.  Emmermann1 , H.  A. von  Waldenfels2 , H.  Mofid1
  • 1Department of Surgery, Israelitisches Krankenhaus in Hamburg, Germany
  • 2Praxisklinik Winterhude for Gynecology and Obstetrics, Hamburg, Germany
Further Information

Publication History

submitted 17 August 2007

accepted after revision 31 August 2007

Publication Date:
30 October 2007 (online)

Laparoscopic surgery has decreased trauma and improved results and natural orifice transluminal endoscopic surgery (NOTES) should be a further step in this direction. However the use of flexible gastroscopes in the abdomen is difficult and the generally chosen transgastric approach is not without risk. Therefore we have carried out a cholecystectomy with a combined transvaginal and transumbilical approach, using laparoscopic instruments. The optic and a dissector were inserted in the posterior fornix of the vagina, and a 5-mm trocar was inserted deep in the umbilicus. After dissection the gallbladder was removed through the vagina. The operation was done without problems within 85 minutes and left no visible scar. The postoperative course was uneventful. In NOTES the transvaginal approach has important advantages over the transgastric method (e. g. regarding sterilization and closure); standard laparoscopic instruments can be used whilst there are no flexible endoscopes that are easier to handle.


C. Zornig, , MD 

Department of Surgery

Israelitisches Krankenhaus

Orchideenstieg 14

22297 Hamburg


Fax: +49-40-511255102

Email: zornig@ik-h.de