NOTES-assisted transvaginal splenectomy: The next step in the minimally invasive approach to the spleen

Eduardo M. Targarona, Cristina Gomez, Ramon Rovira, Juan Carlos Pernas, Carmen Balague, Carlos Guarner-Argente, Sergio Sainz, Manuel Trias

Research output: Contribution to journalArticleResearchpeer-review

39 Citations (Scopus)


Hypothesis. Natural orifice transluminal endoscopic surgery (NOTES) has marked yet another step forward in less-invasive surgical procedures. Access to solid organs located deep in the left hypochondrium can be difficult using this technique but the transvaginal approach with the patient positioned in full lateral decubitus may be an option. Materialand methods. We present the case of a 60-year-old woman with a symptomatic splenic polycystic tumor. The procedure was carried out by a multidisciplinary team using a standard flexible videogastroscope and endoscopic instruments. Transvaginal visualization of the spleen and standard dissection of attachments were feasible, and splenectomy was completed using transvaginal stapling of the splenic hilum. The organ was extracted transvaginally. Results. The postoperative course was uneventful. The patient had minimal postoperative pain and minimal scars, and was discharged on the second postoperative day. Conclusions. Transvaginal access can be safely used for operative visualization, hilum transection, and spleen removal with conventional instrumentation, reducing parietal wall trauma to a minimum. The clinical, esthetic, and functional advantages require further analysis.
Original languageEnglish
Pages (from-to)218-222
JournalSurgical Innovation
Issue number3
Publication statusPublished - 7 Oct 2009


  • Endoscopic surgery
  • Spleen
  • Transvaginal


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