Performing Bariatric Surgery on Previously COVID+ Patients Is Safe and Effective.

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Intraoperative Blood Pressure Lability Is Associated with Postoperative Hemorrhage after Uncomplicated Bariatric Surgery.

Background: Postoperative hemorrhage is a rare complication in bariatric surgery. We aim to determine if differences in blood pressure or perioperative medication administration contribute to postoperative bleeding in patients who were hemodynamically stable intraoperatively.

Methods: This was a retrospective case-control study of all bariatric surgery patients from 2014 to 2017 at a high volume academic center.

Safety and Feasibility of a Lower-Cost Stapler in Bariatric Surgery.

Background: Laparoscopic staplers are integral to bariatric surgery. Their pricing significantly impacts the overall cost of procedures. An independent device company has designed a stapler handle and single-use reloads for cross-compatibility and equivalency with existing manufacturers, at a lower cost.

Gallbladder Agenesis: A Case Report.

Gallbladder agenesis (GA) is an extremely rare congenital entity. The incidence is around 1 per 6500 live births. The majority of patients, estimated between 50 to 70 percent, remain asymptomatic while those who are symptomatic report symptoms mimicking biliary colic.

Impact of preoperative wait time due to insurance-mandated medically supervised diets on weight loss after sleeve gastrectomy. Are patients losing momentum?

Background: Few studies have examined whether preoperative period length, as defined by the amount of time from enrollment in a surgical weight loss program to the day of surgery, affects postoperative weight loss.

Objectives: To identify associations between preoperative period length and postoperative weight loss.

Setting: Single surgeon at an academic medical center in the United States.

Nephrolithiasis after bariatric surgery: A review of pathophysiologic mechanisms and procedural risk.

Obesity alone is a known risk factor for nephrolithiasis, and bariatric surgery has been linked to a higher incidence of post-operative new-onset nephrolithiasis. The mean interval from bariatric surgery to diagnosis of nephrolithiasis, ranges from 1.5 to 3.

Two-Port Laparoscopic Cholecystectomy: 18 Patients Human Experience Using the Dynamic Laparoscopic NovaTract Retractor.

Objective: The concept of reducing the number of transabdominal access ports has been criticized for violating basic tenets of traditional multiport laparoscopy. Potential benefits of reduced port surgery may include decreased pain, improved cosmesis, less hernia formation, and fewer wound complications. However, technical challenges associated with these access methods have not been adequately addressed by advancement in instrumentations.

Transvaginal cholecystectomy learning curve.

Background: There are few surgeons in the United States, within private practice and academic centers, currently performing transvaginal cholecystectomies (TVC). The lack of exposure to TVC during residency or fellowship training, coupled with a poorly defined learning curve, further limits interested surgeons who want to apply this technique to their practice. This study describes the learning curve encountered during the introduction of TVC to our academic facility.

Toward scar-free surgery: an analysis of the increasing complexity from laparoscopic surgery to NOTES.

Background: NOTES is an emerging technique for performing surgical procedures, such as cholecystectomy. Debate about its real benefit over the traditional laparoscopic technique is on-going. There have been several clinical studies comparing NOTES to conventional laparoscopic surgery.

Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey.

Introduction: Simulation training for surgical residents can shorten learning curves, improve technical skills, and expedite competency. Several studies have shown that skills learned in the simulated environment are transferable to the operating room. Residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room.

A comparison of NOTES transvaginal and laparoscopic cholecystectomy procedures based upon task analysis.

Background: A virtual reality-based simulator for natural orifice translumenal endoscopic surgery (NOTES) procedures may be used for training and discovery of new tools and procedures. Our previous study (Sankaranarayanan et al. in Surg Endosc 27:1607-1616, 2013) shows that developing such a simulator for the transvaginal cholecystectomy procedure using a rigid endoscope will have the most impact on the field.

Comparison of immediate postoperative pain after transvaginal versus traditional laparoscopic cholecystectomy.

Background: Transvaginal cholecystectomy (TVC) is the most common natural orifice transluminal surgery (NOTES) performed in women, yet there is a paucity of data on intraoperative and immediate postoperative pain management. Previous studies have demonstrated that NOTES procedures are associated with less postoperative pain and faster recovery times. This study analyzes intraoperative and postoperative opioid use for TVC compared with traditional four-port laparoscopic cholecystectomies (LCs).

Pure transvaginal ventral hernia repair in humans.

Introduction: Transvaginal natural orifice transluminal endoscopic surgery procedures are at the forefront of minimally invasive innovation, remarkable for shorter recovery times and decreased postoperative pain. We aim to demonstrate a novel technique of pure transvaginal laparoscopic ventral hernia repair in a series of patients performed in our institution.

Technique Description: The patient was placed in lithotomy position and steep Trendelenburg.

Transvaginal cholecystectomy: effect on quality of life and female sexual function.

Importance: Transvaginal cholecystectomy (TVC) is the leading natural orifice transluminal endoscopic surgery to date and has the potential to offer improved cosmesis, less pain, and shorter recovery times for female patients.

Objective: To investigate quality of life and female sexual function in our patients undergoing TVC.

Design: A prospective cohort study from August 14, 2009, to June 12, 2012, of TVCs performed at our institution to date.

Complications of transvaginal natural orifice transluminal endoscopic surgery: a series of 102 patients.

Objective: To review the complications encountered in our facility and in previously published studies of transvaginal (TV) natural orifice transluminal endoscopic surgery (NOTES) to date.

Background: TV NOTES is currently observed with critical eyes from the surgical community, despite encouraging data to suggest improved short-term recovery and pain.

Methods: All TV NOTES procedures performed in female patients between 18 and 65 years of age were included.

Pure transvaginal umbilical hernia repair.

Background: Transvaginal natural orifice transluminal endoscopic surgery (NOTES) procedures are at the forefront of minimally invasive innovation, remarkable for shorter recovery times and decreased postoperative pain [1, 2]. Most transvaginal procedures are performed as hybrid procedures [3]. To our knowledge, this is the first video depiction of a pure transvaginal umbilical hernia repair in a human.

Transvaginal natural orifice transluminal endoscopic surgery in the morbidly obese.

Background: The objective of this study is to assess the safety and efficacy of transvaginal (TV) natural orifice transluminal endoscopic surgery (NOTES) operations in morbidly obese patients.

Methods: One hundred seven NOTES operations have been performed at our institution to date, of which 17 were completed in patients with body mass index (BMI) between 35 and 45 kg/m(2). These included 14 cholecystectomies, one appendectomy, and two ventral hernia repairs.

Laparoscopic iliac and iliofemoral lymph node resection for melanoma.

Regional lymphadenectomy in the iliac and groin, originally devised by Basset in 1912, is performed for the treatment of melanoma metastatic to this lymphatic basin. Laparoscopic iliac node dissection may be a valuable management option because it allows performance of the same procedure as in open surgery but with significant benefits such as decreased operative morbidity due to decreased surgical trauma, less violation of the abdominal muscles or the inguinal ligament, reduced postoperative pain, and increased patient satisfaction with the cosmetic appearance. The authors' approach makes use of a laparoscopic technique to offer an alternative to traditionally described lymph node dissection for melanoma.

Construct and face validity of a virtual reality-based camera navigation curriculum.

Introduction: Camera handling and navigation are essential skills in laparoscopic surgery. Surgeons rely on camera operators, usually the least experienced members of the team, for visualization of the operative field. Essential skills for camera operators include maintaining orientation, an effective horizon, appropriate zoom control, and a clean lens.

Pure transvaginal laparoscopic appendectomy.

Background: Natural orifice transluminal endoscopic surgery has been at the forefront of minimally invasive surgery. Benefits include no visible scars, less pain, and shorter recovery time. We describe a video of a 37-year-old female who underwent a pure transvaginal appendectomy (TVA) for acute appendicitis.

Transvaginal cholecystectomy versus single-incision laparoscopic cholecystectomy versus four-port laparoscopic cholecystectomy: a prospective cohort study.

Objective: This report describes the first prospective cohort study comparing transvaginal cholecystectomies (TVC) with single incision laparoscopic cholecystectomies (SILC) and four-port laparoscopic cholecystectomies (4PLC).

Methods: Between May 2009 and August 2010, 14 patients underwent a TVC. These patients were compared with patients who underwent SILC (22 patients) or 4PLC (11 patients) in a concurrent, randomized, controlled trial.

Pure transvaginal appendectomy versus traditional laparoscopic appendectomy for acute appendicitis: a prospective cohort study.

Objective: This report describes the first cohort study comparing pure transvaginal appendectomies (TVAs) to traditional 3-port laparoscopic appendectomies (LAs).

Methods: Between August 2008 and August 2010, 42 patients were offered a pure TVA. Patients who did not wish to undergo a TVA underwent a LA and served as the control group.

Transvaginal NOTES hybrid cholecystectomy.

Background: Initial reports confirm the safety and feasibility of natural orifice transluminal eendoscopic surgery (NOTES) transvaginal hybrid cholecystectomy (TVC). Benefits of TVC include no visible scars, less pain, and shorter recovery. The authors describe a single surgeon's initial experience with TVC through his first 20 cases.