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We retrospectively studied 18 women at our rural hospital in central India, who, under defined criteria, underwent transvaginal appendicectomy using innovative strategically designed submucosal tunnels. The procedure was successfully completed in all but the first three cases. None required additional abdominal trocar or analgesia beyond the first 6\u2009h. The mean operative and hospitalisation times were 27.5\u2009min and 18.5\u2009h, respectively. We had no intraoperative complications and only one patient experienced postoperative self-limiting vaginal spotting. All patients were very pleased with the cosmetic results and sexual life as assessed by locally devised scales. On regular follow-up, all were progressing well. We recommend the method presented, as it is not only feasible and safe but has the potential to improve overall results. Clearly, a larger volume randomised trial would be optimal to confirm our conclusion.<\/jats:p>","DOI":"10.1177\/0049475520921277","type":"journal-article","created":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T01:24:56Z","timestamp":1588209896000},"page":"209-215","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Transvaginal laparoscopic appendectomy using innovative submucosal tunnels: a conducive modification for improving hybrid NOTES access and its critical appraisal"],"prefix":"10.1177","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5434-9465","authenticated-orcid":false,"given":"Priyadarshan A","family":"Jategaonkar","sequence":"first","affiliation":[{"name":"Professor of Surgery, Surgical Gastroenterologist and Advance Laparoscopic Surgeon, Department of Surgery, Division of GI & Minimal Access Surgery, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudeep P","family":"Yadav","sequence":"additional","affiliation":[{"name":"Senior Resident, Department of Plastic & Reconstructive Surgery, Grant\u2019s Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilip","family":"Gupta","sequence":"additional","affiliation":[{"name":"Director, Professor and Head, Department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, 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