Skip to main content
Log in

Transumbilical endoscopic surgery: a preliminary clinical report

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Objective

There has been great interest in natural orifice transluminal endoscopic surgery (NOTES) in recent years. We report another new approach—transumbilical endoscopic surgery (TUES)—which we have performed in 40 cases for liver cysts (3), bleeding ascites (1), chronic appendicitis (10), and gallbladder diseases (26).

Methods

Transumbilical endoscopic liver cyst fenestration, abdominal cavity exploration, appendectomy, and cholecystectomy were performed in a total of 40 patients.

Results

All the operations were completed successfully except one case of intraoperative bleeding in TUES cholecystectomy which was converted to routine laparoscopic surgery. The operating times for TUES cholecystectomy, appendectomy, and liver cyst fenestration were 30–150 min,15–40 min, and 30–90 min, respectively. No postoperative bleeding or bile leakage occurred in this group of patients.

Conclusions

Transumbilical endoscopic surgery is feasible, and would be another option for scarless abdominal surgery. TUES cholecystectomy is technically challenging. Careful selection of patients is important in the initial period of this technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Giday SA, Kantsevoy SV, Kalloo AN (2006) Principle and history of natural orifice translumenal endoscopic surgery (NOTES). Minim Invasive Ther Allied Technol 15:373–377

    Article  PubMed  Google Scholar 

  2. Malik A, Mellinger JD, Hazey JW, Dunkin BJ, MacFadyen BV Jr (2006) Endoluminal and transluminal surgery: current status and future possibilities. Surg Endosc 20:1179–1192

    Article  PubMed  CAS  Google Scholar 

  3. Park PO, Bergstrom M, Ikeda K, Fritscher-Ravens A, Swain P (2005) Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis. Gastrointest Endosc 61:601–606

    Article  PubMed  Google Scholar 

  4. Fuente SG, DeMaria EJ, Reynolds JD, Portenier DD, Pryor A (2007) New development in surgery: natural orifice transluminal endoscopic surgery (NOTES). Arch Surg 142:295–297

    Article  PubMed  Google Scholar 

  5. Zhu JF (2007) Scarless endoscopic surgery: NOTES or TUES. Surg Endosc 21:1898–1899

    Article  PubMed  Google Scholar 

  6. Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA, Kantsevov SV (2004) Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60:114–117

    Article  PubMed  Google Scholar 

  7. Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–826

    Article  PubMed  Google Scholar 

  8. Zorron R, Maggioni LC, Pombo l, Oliverira AL, Carvalho GL, Filgueiras M (2008) NOTES transvaginal cholecystectomy: preliminary clinical application. Surg Endosc 22:542–547

    Article  PubMed  CAS  Google Scholar 

  9. Scott DJ, Tang SJ, Fernandez, Bergs R, Goova MT, Zeltser I, Kehdy FJ, Cadeddu JA (2007) Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments. Surg Endosc 21:2386–2316

  10. Koontz CS, Smith LA, Burkholder HC, Higdon K, Aderhold R, Carr M (2006) Video-assisted transumbilical appendectomy in children. J Pediatr Surg 41:710–712

    Article  PubMed  Google Scholar 

  11. Pappalepore N, Tursini S, Marino N, Lisi G, Lelli Chiesa P (2002) Transumbilical laparoscopic-assisted appendectomy (TULAA): a safe and useful alternative for uncomplicated appendicitis. Eur J Pediatr Surg 12:383–386

    Article  PubMed  CAS  Google Scholar 

  12. Cuesta MA, Berends F, Veenhof AA (2007) The “invisible cholecystectomy”: a transumbilical laparoscopic operation without a scar. Surg Endosc Oct 18. doi:10.1007/s00464-007-9588-y

  13. Zornig C, Emmermann A, von Waldenfels HA, Mofid H (2007) Laparoscopic cholecystectomy without visible scar: combined transvaginal and transumbilical approach. Endoscopy 39:913–915

    Article  PubMed  CAS  Google Scholar 

  14. Zhu JF, Ma YZ, Yu JL, Hu H (2008) Transumbilical endoscopic cholecystectomy with the trichannel trocar technique: a porcine feasibility study. Surg Innov 15:95–99

    Article  Google Scholar 

  15. Park S, Bergs RA, Eberhart R, Baker L, Fernandez R, Cadeddu JA (2007) Trocar-less instrumentation for laparoscopy magnetic positioning of intra- abdominal camera and retractor. Ann Surg 245:379–384

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jiang Fan Zhu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhu, J.F., Hu, H., Ma, Y.Z. et al. Transumbilical endoscopic surgery: a preliminary clinical report. Surg Endosc 23, 813–817 (2009). https://doi.org/10.1007/s00464-008-0086-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-0086-7

Keywords

Navigation