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Surgical removal of the gallbladder has evolved from an open technique to a minimally invasive laparoscopic technique. Natural-orifice transluminal endoscopic surgery (NOTES) is a revolutionary procedure that uses flexible endoscopes to access the peritoneal cavity without leaving visible scars.
Researchers in Brazil, who had ties to a manufacturer of equipment used in the study, reported their experience with a transvaginal, video-assisted, laparoscopic approach to NOTES cholecystectomy in 32 women. For each patient, a 5-mm intraumbilical trocar was used as the working port for dissection and clipping as well as for examination of the pelvis to allow safe transvaginal puncture. A 12-mm bariatric trocar was placed in the posterior vaginal fo…