In breakthrough surgery, doctors go through vagina to remove abdominal organ

October 7, 2010

A team of Ohio State surgeons is among the first in the country to remove a patient’s gallbladder entirely through her birth canal. Surgeons here are pioneering the incisionless technique as part of a study that will lead to the first trial in the world to compare laparoscopic and transvaginal surgery in this arena.

Gallbladder removal is one of the most common surgeries across the country: U.S. surgeons remove a gallbladder once a minute, every minute of the day.
Ohio State surgeons performed their first transvaginal gallbladder removal last month on a 42-year-old Columbus woman. Surgeons punched a small hole in her vaginal muscle, then fed tiny instruments into her abdomen to remove her gallbladder. This surgery took less than 90 minutes and the patient went home just hours later.

Because the vaginal region has fewer nerve endings, the surgery was virtually pain-free and leads to a more comfortable healing process when compared to traditional techniques.

“In the past, we would make about a six-inch cut into a patient’s abdomen to remove their gallbladder. This was not only more painful, but took longer to heal and carried higher risk for infection,” explains Dr. Vimal Narula, the surgeon who performed Ohio State’s first procedure.

“Because we’re working in the birth canal, which has good blood supply, things heal faster, leading to less overall pain and less post-operative discomfort.”

The only discomfort associated with this surgery a woman may experience may come from a small incision at the belly button where surgeons insert a small camera to help guide surgical instruments.

Although transvaginal gallbladder surgeries are experimental and rare, more are being scheduled, testament to the potential of natural orifice translumenal endoscopic surgery (NOTES).

In 2006, Ohio State surgeons were among the first in the country to use incisionless technology to diagnose abdominal malignancies and cancer staging through the mouth. Since then, surgeons here have performed more than 120 related procedures with help from an endoscopic camera and remote-controlled surgical cutting tools.

“We’re one of only a few programs in the country with a leading role in a study to examine the use of natural orifice surgery as another emerging technology within the field of minimally invasive therapy,” said Narula.

*Digestive Diseases Statistics for the United States, National Institute of Diabetes and Digestive and Kidney Diseases (NIH). Retrieved September 2010 from: