[Notes-hybrid: splenectomy (transvaginal/umbilical)].

In the search of less invasive surgery, laparoscopic procedures through natural orifices accesses have begun to be standardized Considering that women have the higher prevalence of idiopathic thrombocytopenic purpura, the purpose of this presentation is to demonstrate our first experience performing a hybrid NOTES (natural orifice transluminal endoscopic surgery) splenectomy, with the transvaginal and umbilical-multi-port access as doors to perform the procedure. We present a 30-year-old woman with body mass index 22 kg/m2 and platelet count 55,000 per microliter-x103/uL. A refractory autoimmune thrombocytopenic purpura was diagnosed.