Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1714
Peer-review started: October 29, 2020
First decision: December 8, 2020
Revised: December 22, 2020
Accepted: January 6, 2021
Article in press: January 6, 2021
Published online: March 6, 2021
Pure natural orifice transluminal endoscopic surgery (NOTES) for colorectal cancer is a complex procedure and rarely used in clinical practice because of the ethical concerns and technical challenges, including loss of triangulation, in-line orientation, and instrument collision. Transvaginal (v) NOTES, however, can overcome these technical challenges. We report a case of pure vNOTES right hemicolectomy for colon cancer, attached with surgical video.
A 65-year-old woman with a 2-year history of intermittent diarrhea was diagnosed with ascending colon adenocarcinoma by colonoscopy and biopsy. Pure vNOTES right hemicolectomy was performed with complete mesocolic excision by well-experienced surgeons. The operative time was 200 min and the estimated blood loss was 30 mL. No intraoperative or postoperative complications occurred within 30 d after the surgery. The visual analog scale pain score on postoperative day 1 was 1 and dropped to 0 on postoperative days 2 and 3. The patient was discharged at postoperative day 6. The pathologic specimen had sufficient clear resection margins and 14 negative harvested lymph nodes.
vNOTES right hemicolectomy, performed by well-experienced surgeons, overcomes the technical challenges of pure NOTES and may be feasible for colon cancer.
Core Tip: Pure natural orifice transluminal endoscopic surgery (NOTES) for colon cancer is rarely used in clinical practice because of the complex surgical procedures, technical challenges, and ethical concerns. To the best of our knowledge, there has been no previous report on transvaginal (v) NOTES right hemicolectomy for colon cancer. In this paper, we report our preliminary clinical experience with successful pure vNOTES treatment of a 65-year-old woman with ascending colon adenocarci-noma.