{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:03:16Z","timestamp":1740106996124,"version":"3.37.3"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Private Universit\u00e4t Witten\/Herdecke gGmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Hysterectomy alters the anatomy of the posterior vaginal vault used as access for transvaginal\/transumbilical hybrid NOTES cholecystectomy (NC), creating potential consequences for the feasibility and complication rate of the procedure. Therefore, the aim of our retrospective analysis of prospectively collected data was to analyze the postoperative course after NC in previously hysterectomized (PH) patients compared with patients who had not undergone hysterectomy (NH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 126 NH patients and 50 PH patients aged over 42 who had an NC from 12\/2008 to 04\/2021 were compared regarding age, body mass index (BMI), ASA classification, number of percutaneous trocars, need for intraoperative urinary bladder catheterization, length of procedure, conversion rate, and intraoperative and postoperative complication rate according to the Clavien\/Dindo classification, Comprehensive Complication Index (CCI), mortality, and hospital length of stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PH patients were older than NH patients (63.0 vs 51.5\u00a0years;<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) but did not differ significantly in ASA classification (<jats:italic>P<\/jats:italic>\u2009=\u20090.595) and BMI (26.8 vs 27.9\u00a0kg\/m<jats:sup>2<\/jats:sup>;<jats:italic>P<\/jats:italic>\u2009=\u20090.480). They required more percutaneous trocars (<jats:italic>P<\/jats:italic>\u2009=\u20090.047) and longer procedure time (66.0 vs. 58.5\u00a0min;<jats:italic>P<\/jats:italic>\u2009=\u20090.039). Out of all 287 scheduled NC only one had to be \u201cconverted\u201d to traditional laparoscopic cholecystectomy. Intraoperative and postoperative complication rates, Clavien\/Dindo classification, CCI, need for intraoperative urinary bladder catheterization, and length of stay did not differ significantly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results indicate an increased degree of difficulty of NC in PH patients, although there is no major impact on intraoperative and postoperative complication rates. Urinary bladder perforation is a specific access-related complication in PH patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00423-021-02401-8","type":"journal-article","created":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T06:02:46Z","timestamp":1640757766000},"page":"655-662","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does a prior hysterectomy complicate transvaginal\/transumbilical hybrid NOTES cholecystectomy?\u2014a comparative analysis of prospectively collected data"],"prefix":"10.1007","volume":"407","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1311-7326","authenticated-orcid":false,"given":"Dirk R.","family":"Bulian","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-7726","authenticated-orcid":false,"given":"Axel","family":"Sauerwald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5092-0222","authenticated-orcid":false,"given":"Panagiotis","family":"Thomaidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6372-1273","authenticated-orcid":false,"given":"Claudia S.","family":"Seefeldt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1505-0425","authenticated-orcid":false,"given":"Dana C.","family":"Richards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-1436","authenticated-orcid":false,"given":"Sissy-A.","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4538-6050","authenticated-orcid":false,"given":"Niklas J.","family":"Weltermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3374-1150","authenticated-orcid":false,"given":"Markus M.","family":"Heiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1647-4836","authenticated-orcid":false,"given":"Claus F.","family":"Eisenberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,29]]},"reference":[{"key":"2401_CR1","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1016\/j.jss.2019.06.012","volume":"244","author":"E Yang","year":"2019","unstructured":"Yang E, Nie D, Li Z (2019) Comparison of major clinical outcomes between transvaginal notes and traditional laparoscopic surgery: a systematic review and meta-analysis. 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Due to the retrospective design of this analysis, additional approval by a Research Ethics Committee was not required according to our Institutional Review Board. Written and informed consent regarding the performed procedures as well as potential future analyses of their data was obtained from all patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written and informed consent regarding the performed procedures as well as potential future analyses of their data was obtained from all patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable\/see above.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}