STUDY OBJECTIVE: To show that in selected cases transvaginal NOTES can be a frugally innovative approach for adhesiolysis and that it can be performed in a low-cost setting. DESIGN: Step-by-step explanation of the technique using videos and pictures (educative video). @entity1 AND MEASUREMENTS: A 51-year old (para 2, gravida 2) presented with meso- and @entity158 . Two years before, an @entity14147 had been repaired using a Proceed Ventral Patch mesh. The diagnosis of @entity158 caused by adhesions was made, and laparoscopic adhesiolysis was planned. On ultrasound, a @entity43 was visualized. Because of the suspected umbilical location of the adhesions, we decided to use a transvaginal NOTES approach to perform adhesiolysis and left adnexectomy. Pathological examination confirmed a small benign papillary serous adenofibroma of the ovary. INTERVENTIONS: A transvaginal NOTES approach to perform adhesiolysis combined with left adnexectomy using only standard reusable laparoscopic instruments and a low-cost self-constructed NOTES port. MAIN RESULTS: The procedure and postoperative recovery were uneventful. No minor or major complications occurred. The @entity1 has been cured of her @entity158 . CONCLUSION: Transvaginal NOTES is a novel approach that requires further validation. This case report shows that transvaginal NOTES can be used to perform adhesiolysis for @entity490 and that it can be performed in a low-cost setting without the need for expensive ports or disposable instruments.

Poor XXXX 's NOTES: Can It Be a Good Approach for Adhesiolysis? A First Case Report With Video Demonstration.

@entity1 :: ('9606', 'Species') :: ['patient', 'PATIENTS'] @entity43 :: ('MESH:D010051', 'Disease') :: ['small left ovarian fibroma'] @entity158 :: ('MESH:D010146', 'Disease') :: ['hypogastric pain', 'pain'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity14147 :: ('MESH:D006554', 'Disease') :: ['umbilical hernia']
@entity1 :: (9606,Species) :: ['Man']
