A radiological investigation of the hepatorenal space: the importance of the ventral decubitus for safer percutaneous right renal access.

We investigated anatomical and radiological morphometric parameters, aiming to minimize the risk of hepatic and colonic injuries during right percutaneous kidney access under either ventral or dorsal decubitus of patients. Prone and supine abdominal computerized tomographic examinations from 31 normal adult volunteers (men = 12; women = 19; without history of abdominal pathology) were analyzed morphometrically in order to study the dynamic anatomical relations between the liver and the right kidney. The age of the volunteers ranged from 22 to 64 years old (mean +/- SD = 42.

NOTES: transvaginal for cancer diagnostic staging: preliminary clinical application.

Laparoscopy is now a reliable method for staging gastrointestinal cancer, orienting the therapy, and avoiding unnecessary laparotomy. Natural orifice transluminal endoscopic surgery (NOTES) is an emerging concept with potential advantages for patient recovery. The first case of clinical diagnostic application of transvaginal NOTES for diagnostic cancer staging is presented.

NOTES. Transvaginal cholecystectomy: report of the first case.

Natural Orifice Translumenal Endoscopic Surgery is a new development area with potential advantages for patients. However, technical and ethical challenges involved in perforation and closure of a healthy organ, as seen in transgastric access, and lack of comprehension of physiopathology of these approaches haven't allowed clinical application. The present study, based on previous animal experiments, describes the first clinical application of transvaginal Natural Orifice Translumenal Endoscopic Surgery.