Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) for adnexal tumors

Surg Endosc. 2009 Nov;23(11):2445-9. doi: 10.1007/s00464-009-0408-4. Epub 2009 Apr 3.

Abstract

Background: Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) has shown promise as a minimally invasive laparoscopic surgery technique.

Objective: To investigate the feasibility and surgical outcome of E-NOTES for adnexal tumors.

Methods: We performed E-NOTES in 12 patients with adnexal tumors through a 2-cm intraumblical incision. A single-port access system comprising a wound protractor and a surgical glove was used. A prospective data registry was used in this study.

Results: Since 1 July 2008, 12 patients have undergone E-NOTES for adnexal tumors. E-NOTES in all 12 cases was completed successfully without conversion to standard laparoscopic approach. Median operative time for creating an E-NOTES access system and the ensuing operative procedures was 6 min (range 5-15 min) and 73 min (range 25-110 min), respectively. Median blood loss was <10 ml. No complications requiring treatment occurred.

Conclusion: E-NOTES is a feasible alternative method for resection of adnexal tumors with better cosmetic outcome. More experience and instrumental improvement suitable for E-NOTES are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adnexal Diseases / pathology
  • Adnexal Diseases / surgery
  • Adult
  • Endoscopy / methods*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Genital Neoplasms, Female / diagnosis
  • Genital Neoplasms, Female / surgery*
  • Humans
  • Korea
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Ovariectomy / adverse effects
  • Ovariectomy / methods
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Risk Assessment
  • Treatment Outcome
  • Umbilicus / surgery