Early postoperative complications of transvaginal access in minimally invasive sigmoid colon procedures.

OBJECTIVES: The aim of the study was to evaluate early (the first 30 days) postoperative complications after transvaginal resection of the sigmoid colon. MATERIAL AND METHODS: A total of 23 laparoscopy-assisted transvaginal resections of the sigmoid colon and 1 NOTES transvaginal sigmoid resection were performed in the course of 3 years. Postoperative complications were recorded in a prospective manner. RESULTS: In the group of 24 patients operated on using the transvaginal approach, 6 (25%) complications were recorded, including 3 urinary tract infections, 2 vaginal bleedings, and 1 abdominal trocar site hernia. CONCLUSION: Early postoperative complication rate after transvaginal resection of the sigmoid colon is relatively low and the clinical complications are not severe.

Transvaginal sigmoid cancer resection: first case with 12 months of follow-up--technique description.

OBJECTIVE: Several minimally invasive techniques using natural orifices as an entrance site to the peritoneal cavity have been described recently. Pure natural orifice translumenal endoscopic surgery (NOTES) techniques have been mainly implemented to perform cholecystectomies and appendectomies, while more complex operations like colon resections have been described in a hybrid setting and with the use of the transumbilical approach. Here we describe the technique of transvaginal sigmoid colon resection for cancer with standard laparoscopy equipment. MATERIALS AND METHODS: After developing the transvaginal technique of sigmoid colon resection in an experimental sheep model, we have performed this operation in a human patient for cancer. Twelve months of follow-up is reported. RESULTS: A totally transvaginal R0 resection of the sigmoid colon for adenocarcinoma has been successfully performed in a female patient with laparoscopy equipment. The specimen included 13 lymph nodes, all of which were free of metastasis. Twelve months after surgery the patient is alive with no evidence of disease. CONCLUSION: A pure transvaginal NOTES approach to sigmoid colon cancer is feasible in human patients.

Totally transvaginal resection of the descending colon in an experimental model.

BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES), although in its embryonic phase, is currently experiencing important developments. The technique has been successfully applied for cholecystectomies and appendectomies. However, several doubts exist as to the technical limitations and feasibility of NOTES in other clinical settings. METHODS: The authors have performed totally transvaginal colon resections in a sheep model. Although completion of the surgery was possible through the transvaginal route, the addition of a transumbilical laparoscope was used as an added safety measure. RESULTS: Totally transvaginal resection of the sigmoid colon was performed for two sheep with no intra- or postoperative complications. CONCLUSION: Totally transvaginal resection of the colon (pure NOTES) is feasible in a sheep model.

Carcinoma suprarrenocortical. Abordaje terapéutico en estadio avanzado / Adrenal cortical carcinoma: therapeutic approach in advanced-stage disease

Presentamos el caso clínico de una mujer de 33 años diagnosticada de carcinoma suprarrenocortical en estadio avanzado. Describimos la forma de presentación clínica, los métodos diagnósticos empleados y el tratamiento, especialmente en su aspecto quirúrgico, que puede precisar en determinadas ocasiones conocimientos y habilidades en cirugía hepática y vascular para intentar conseguir la resección completa del tumor y mejorar la supervivencia en estos pacientes, generalmente muy jóvenes; asimismo, realizamos una actualización bibliográfica diagnosticoterapéutica de esta neoplasia, rara en su frecuencia pero agresiva en su evolución (AU)