Historia de la Cirugia Endoscopica Transvaginal por Orificios Naturales

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Historia Cirugia Transvaginal.

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  • Historically Dr. D.O. Ott performed a ventroscopy appendectomy during vaginal hysterectomy on April 26, 1906 and was published in 1908 : Ott D.O. (1908). Results achieved by the use of direct illumination of the abdominal cavity, colon and urinary bladder during operations and for examination. Russky Vrach 43: 3-11.
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  • Soboleff J. de. Die Appendektomie als begleitende Operation bei vaginalen Coeliotomien. Monatsschrift für Geburtshilfe und Gynäkologie 1910;32(Suppl 1):46–48 (DOI:10.1159/000289337) J. de Soboleff. Appendectomy accompanying Vaginal Celiotomy : Five cases,. Monatsschrift für Geburtshülfe und Gynäkologie. Berlin, published in 1910.
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  • Re Slide 32 : the same month Drs. Bernhardt J, Gerber B, Schober HC, Kähler G, Ludwig K. Published : NOTES--case report of a unidirectional flexible appendectomy.Int J Colorectal Dis. 2008 May;23(5):547-50. PMID: 18256848
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  • Tsin DA, Castro-Perez R, Davila MR, Davila F.
  • Historia de la Cirugia Endoscopica Transvaginal por Orificios Naturales

    1. 1. Historia de la Cirugia Endoscopica Transvaginal por Orificios Naturales www.culdoscopy.com
    2. 2. Introduction <ul><li>The Evolution of Transvaginal Peritoneoscopy </li></ul>
    3. 3. Anatomy <ul><li>The description of the recto-uterine pouch is credited to the work of Dr. James Douglas. </li></ul><ul><li>“ A description of the peritoneum and that part of the membrana cellularis which lies outside” London, 1730 . </li></ul>
    4. 4. VENTROSCOPIA <ul><li>A resourceful use of colpotomy was presented by Dr. Dmitri Ott at the Meeting of The Gynecology and Obstetrical Society of Saint Petersburg in Russia held on April 19, 1901; that was the introduction of Ventroscopy. </li></ul>
    5. 5. Dr. Ott’s Publication of Ventroscopia
    6. 6. Meeting of the Medical Society of Wien in 1937 <ul><li>Dr. Emanuel Klaften presented the technique of Colpolaparoscopy. </li></ul><ul><li>Dr. Klaften designed an optical instrument with a light source and a 90-degree angle lens. </li></ul>
    7. 7. Klaften Colpolaparoscope
    8. 8. CULDOSCOPY <ul><li>Drs. A. Decker and T. Cherry described Culdoscopy in 1944. The patients were in the knee-chest posture, which allowed for better visualization. Most of the studies were performed at Knickerbocker Hospital in Manhattan, New York. </li></ul>
    9. 9. Topic Two
    10. 11. THL/Fertiloscopy <ul><li>Transvaginal Hydrolaproscopy (THL), a technique related to culdoscopy, was introduced in 1998 utilizing new technology. Placing a 3mm in diameter culdoscope, and using normal saline as a distention media, this office-based procedure is performed with the patient in the lithotomy position, and anesthesia is not required. The procedure is used as a diagnostic tool for infertility, pelvic pain, and endometriosis. Other minor operative procedures could also be done. </li></ul>
    11. 12. THL/Fertiloscopy <ul><li>Details about this topic </li></ul><ul><li>Supporting information and examples </li></ul><ul><li>How it relates to your audience </li></ul>
    12. 13. Flexible Culdoscopy (1999) <ul><li>Flexible instrument technology is used for the visualization of the pelvic. This device is used with the patient in the knee-chest posture. The flexible culdoscope gives a visualization range from 0 degree to 180 degrees. This permits the viewing of areas in the blind spots of rigid instruments like the bladder, anterior uterine surface, and the posterior cul-de-sac. </li></ul>
    13. 14. CULDOLAPAROSCOPY <ul><li>Dr. Tsin began, in 1998, utilizing a vaginal port, specifically to assist with minilaparoscopy. The project began utilizing a 12 mm trocar inserted into the cul-de-sac under minilaparoscopic surveillance. This is a new concept where the function of the ports change depending on the nature or stage of the procedure. The surgeon has the opportunity to utilize different size scopes, and the team has the ability to operate from different angles and with good triangulation. </li></ul>
    14. 15. Real Life <ul><li>Give an example or real life anecdote </li></ul><ul><li>Sympathize with the audience’s situation if appropriate </li></ul>Culdolaparoscopy Appendectomy (1998)
    15. 16. CULDOLAPAROSCOPY <ul><li>During 1999, Dr. Tsin et al. began to use this approach in the visualization and operation during vaginal hysterectomy. This time, the resemblance to ventroscopy was obvious. We were able to insufflate and visualize the abdomen, and perform simultaneous cholecystecomies, difficult oophorectomies, and salpingoophorectomies. Later, the posterior colpotomy was used for the same task. </li></ul>
    16. 17. Culdolaparoscopic Cholecystectomy (1999) Culdolaparoscopic Cholecystectomy During Vaginal Hysterectomy . Tsin DA, Sequeira J, Giannikas G. JSLS 2003;7:171-172.
    17. 18. Kallo et al. (2004) <ul><li>Gastrointest Endosc. 2004 Jul;60(1):114-7 </li></ul><ul><li>Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity . </li></ul><ul><li>Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland USA . </li></ul>
    18. 19. And then came NOTES
    19. 20. MANOS <ul><li>Minilaparoscopy-Assisted Natural Orifice Surgery </li></ul><ul><li>Daniel A. Tsin, MD, Liliana T. Colombero, MD, Johann Lambeck, MD, Panagiotis Manolas, MD </li></ul><ul><li>JSLS (2007)11:24–29 </li></ul><ul><li>100 cases (human experience) </li></ul>
    20. 21. Transvaginal Endoscopic Cholecystectomy <ul><li>1999, August 20. Tsin DA, et al. </li></ul><ul><li>  </li></ul><ul><li>2007, March 13. Zorron R, et al. </li></ul><ul><li>  </li></ul><ul><li>2007, March 20. Bessler M, et al. </li></ul><ul><li>  </li></ul><ul><li>2007, April 2. Marescaux J, et al. </li></ul>
    21. 22. Transvaginal Endoscopic Cholecystectomy <ul><li>1999, August 20. Tsin DA, et al. </li></ul><ul><li>2007, March 13. Zorron R, et al. </li></ul><ul><li>2007, March 20. Bessler M, et al. </li></ul><ul><li>2007, April 2. Marescaux J, et al. </li></ul>Rigid Instruments Flexible Instruments Flexible Instruments Flexible Instruments
    22. 23. Then around the world
    23. 24. Safety <ul><li>Angel Cuadrado-Garcia, MD, PhD, from the Department of General Surgery, Hospital Son Llatzer, Palma de Mallorca, Spain, reported the safety of the hybrid technique (MANOS) in cholecystectomy as an alternative to conventional laparoscopic cholecystectomy. </li></ul>
    24. 25. Patient Satisfaction <ul><li>J Laparoendosc Adv Surg Tech A. 2010 Mar;20(2):119-21. </li></ul><ul><li>Postoperative patient attitudes and perceptions of transvaginal cholecystectomy. </li></ul>Tsin DA, Castro-Perez R, Davila MR, Davila F.
    25. 26. Advanced Flexible Endoscopes <ul><li>The Transport advanced operating endoscope [USGI Medical, San Juan Capistrano, California]. </li></ul><ul><li>The Cobra triangulating scope [USGI Medical, San Juan Capistrano, California]. </li></ul><ul><li>The Olympus R [Olympus, Center Valley, Pennyslvania] is a commercially available dual channel operating scope. </li></ul>
    26. 27. More Flexible Endoscopes The Eagle Claw [Olympus, Center Valley, Pennsylvania] suturing device with a semi-circular needle. Transdouglas Endoscopic Device
    27. 28. Flexible Instruments Novare Covidien Ethicon Endosurgical
    28. 29. Guidelines <ul><li>ASERNIP-S </li></ul><ul><li>NOSCAR </li></ul><ul><li>NESA/NOS </li></ul>
    29. 30. Magnets Dr. Guillermo Dominguez, Poza Rica, Mexico (2008)
    30. 31. Dr. Fausto Davila Poza Rica, Mexico (2008) Rein and Hook
    31. 32. Transvaginal Endoscopic Appendectomy <ul><li>J Am Assoc Gynecol Laparosc. 2001 Aug;8(3):438-41. </li></ul><ul><li>Operative culdolaparoscopy: a new approach combining operative culdoscopy and minilaparoscopy. </li></ul><ul><li>Tsin DA, Colombero LT, Mahmood D, Padouvas J, Manolas P. </li></ul><ul><li>Surg Endosc. 2008 May;22(5):1343-7. Epub 2008 Mar 18. </li></ul><ul><li>Transvaginal endoscopic appendectomy in humans: a unique approach to NOTES--world's first report. </li></ul><ul><li>Palanivelu C, Rajan PS, Rangarajan M, Parthasarathi R, Senthilnathan P, Prasad M. </li></ul>Rigid Instruments Flexible Instruments
    32. 33. Nephrectomy <ul><li>Feasibility of Transvaginal Natural Orifice </li></ul><ul><li>Transluminal Endoscopic Surgery–Assisted </li></ul><ul><li>Living Donor Nephrectomy: Is Kidney </li></ul><ul><li>Vaginal Delivery the Approach of the Future? </li></ul><ul><li>Antonio Alcaraz, Mireia Musquera, </li></ul><ul><li>Lluis Peri, Laura Izquierdo, et al. </li></ul><ul><li>European Urology . 2011; 59:1019–1025. </li></ul>
    33. 34. Sigmoidectomy <ul><li>Lacy AM , Delgado S, Rojas OA, Almenara R, </li></ul><ul><li>Blasi A,Llach J. MA-NOS radical sigmoidectomy: report of a transvaginal resection in the human. Surg Endosc 2008; 22 :1717-1723. </li></ul><ul><li>Burghardt J , Federlein M, Müller V, Benhidjeb T, Elling D, Gellert K. [Minimal invasive transvaginal right hemicolectomy: report of the first complex NOS (natural orifice surgery) bowels operation using a hybrid approach] Zentralbl Chir 2008; 133 :574-576. </li></ul>
    34. 35. Experimental Secured Independent Tools Micro robotics
    35. 36. Thank you for your attention www.culdoscopy.com For more information visit:

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