- What Is
What is transvaginal cholecystectomy?
Transvaginal cholecystectomy is a novel surgical procedure to remove the gallbladder through the vaginal route.
It is one of the three types of cholecystectomy—apart from the traditional open cholecystectomy and laparoscopic cholecystectomy—that is done to treat patients with an inflamed gallbladder (cholecystitis).
The decision to opt for transvaginal cholecystectomy over the other two methods remains at the discretion of the patient as also on the surgeon’s expertise.
What are the advantages of transvaginal cholecystectomy?
Transvaginal cholecystectomy can be done in either of the two ways:
- Natural orifice transluminal endoscopic surgery (NOTES) alone
- A combination of NOTES and laparoscopy (hybrid NOTES)
The advantages of transvaginal cholecystectomy via NOTES over the other types of cholecystectomy include the following:
When is transvaginal cholecystectomy avoided?
A doctor may recommend you against transvaginal cholecystectomy and instead prefer laparoscopic cholecystectomy or open cholecystectomy if you
- Have gangrenous cholecystitis (a deadly complication of cholecystitis)
- Are pregnant
- Have delivered in the last two months
- Have a history of
If complications arise during the surgery, the doctor can decide to convert transvaginal cholecystectomy to either the laparoscopic or open approach.
How is transvaginal cholecystectomy performed?
Before the surgery
- The doctor will evaluate you to know if you are fit for the surgery and general anesthesia. You are not allowed to eat or drink anything for 8-12 hours, except for a few sips of water with the necessary medicines, before the surgery.
During the surgery
- You will be given general anesthesia to make you sleep throughout the procedure.
- The surgeon makes a small incision of about 5 mm on your belly button.
- The surgeon introduces an endoscope/a laparoscope (a long tube-like camera) through the incision to visualize the gallbladder.
- The surgeon fills the abdominal cavity with air.
- Next, the surgeon introduces an instrument known as a speculum into the vagina to visualize the interior of the vagina and then makes a small incision on the vaginal wall.
- The surgeon inserts another endoscope through the vaginal incision and directs it further to visualize the gallbladder in the abdomen.
- Once the gallbladder is identified, the surgeon cuts it with the help of instruments inserted through the previous endoscope on your belly button.
- Hemostasis (arresting of bleeding) is achieved.
- The surgeon then removes the gallbladder out of the vaginal route in a retrieval bag.
- The surgeon cleans the incision at the abdomen and applies a bandage; the surgeon then sutures the vagina.
After the surgery
- You are shifted to the general ward and observed for several hours after the surgery.
- A liquid diet is started after 12-24 hours after the surgery.
- Painkillers and antibiotics are initially given intravenously (IV) and later by mouth.
- After regular monitoring, you are discharged usually after one or two days.
- You need to avoid sex for about two weeks to one month after the surgery as advised.
- Follow-up with the surgeon will be scheduled generally after seven days of your discharge and later as advised.
What are the complications of transvaginal cholecystectomy?
The uterus is only passed by and remains uninjured, whereas the endoscope moves toward the appendix, so it is unlikely that a cholecystectomy performed with the transvaginal approach will affect your fertility.
The possible complications of transvaginal cholecystectomy include the following:
- Bowel or rectal injury
- Abdominal adhesions (bands of scar-like tissue between two or more organs)
- Abdominal abscess (collection of pus in the abdomen)
As the gallbladder is located close to the liver and the bile duct, any technique of cholecystectomy carries a risk of
Latest Digestion News
Health Solutions From Our Sponsors
Medscape Medical Reference
Top What Is Transvaginal Cholecystectomy Related Articles
Laparoscopic CholecystectomyCholecystectomy is surgery to removed the gallbladder. A laparoscopic cholecystectomy is a less invasive way to remove the gallbladder using a laparoscope. The benefit of laparoscopic cholecystectomy is a shorter recovery time. But if you have previously had surgery in the area of your gallbladder, if you tend to bleed a lot or if you have any problem that would make it hard for your doctor to see your gallbladder, an open surgery may be better for you.
Gallbladder CancerGallbladder cancer is a rare form of cancer with symptoms that include jaundice, abdominal pain, fever, nausea and vomiting, abdominal lumps, and bloating. Risk factors include being female and Native American. Treatment of gallbladder cancer depends upon the stage of the cancer, the type of gallbladder cancer, and whether the cancer can be removed by surgery.
Gallbladder Pain: Relief, Causes, and DietGallbladder pain (often misspelled "gall bladder") is generally produced by of five problems, biliary colic, cholecystitis, gallstones, and pancreatitis. Causes of gallbladder pain include intermittent blockage of ducts by gallstones or gallstone inflammation and/or sludge that also may involve irritation or infection of surrounding tissues, or when a bile duct is completely blocked. Treatment of gallbladder depends on the cause, which may include surgery.
Gallbladder PictureFront View of the Gallbladder. The gallbladder is a small pouch that sits just under the liver. See a picture of the Gallbladder and learn more about the health topic.
How Long Does a Postcholecystectomy Syndrome Last?A Postcholecystectomy syndrome occurs when abdominal symptoms arise after gallbladder surgery. This syndrome is temporary and heals with medications.
Is Laparoscopic Cholecystectomy Major Surgery?Laparoscopic cholecystectomy, or gallbladder removal, is a major surgery, but it's a routine and minimally invasive one. In a laparoscopic cholecystectomy the surgeon makes several small 1 inch long incisions. The surgeon inserts a thin tube with a camera (laparoscope) into the incision and removes the gallbladder with tiny surgical tools, guided by the images on the camera.