Transvaginal Cholecystectomy Versus Laparoscopic Cholecystectomy in Patients With Biliary Colic
Transvaginal Cholecystectomy Versus Laparoscopic Cholecystectomy in Patients With Biliary Colic
A safe and effective transvaginal approach accessing the abdominal cavity through the vagina
 rather than the abdominal wall is today considered a routine approach for many gynecologic
 surgeries.

 First described by Dr. Ott in Germany in 1901, it is used routinely for transvaginal surgery,
 for example, transvaginal hysterectomies. This transvaginal technique has been shown to
 compare favorably to a laparoscopic abdominal approach because of less postoperative pain,
 the total elimination of abdominal wall hernias and wound infections, earlier recovery and
 better cosmesis.

 Although routinely used in gynecological surgery, the advantages of the vaginal approach have
 not been utilized for general surgery applications such as cholecystectomies. Open or
 laparoscopic cholecystectomy accessing the abdominal cavity through abdominal wall incisions
 is currently still considered the standard of care in general surgery for patients with
 symptomatic gallbladder disease.

 The investigators intend to access the abdominal cavity through the posterior vaginal fornix
 instead of the transabdominal approach that is now performed routinely. So far, this method
 of accessing the abdominal cavity through the transvaginal approach for the purpose of
 performing intraabdominal general surgery.

 The investigators' transvaginal approach has the strong potential to further decrease
 invasiveness and take minimally invasive surgery to the next level in order to benefit the
 patient even more by minimizing postoperative pain, eliminating the risk of abdominal hernias
 and wound infections, improving cosmetic appearance and enabling the patient to return to
 routine activity and work earlier. First preliminary studies show these advantages but
 further research needs to be done to confirm these early positive results.
Inclusion Criteria:

 -  Female.

 -  Age between 18 and 65 years old.

 -  Biliary dyskinesia with documented Gallbladder EF < 30% or diagnosis of biliary colic
 with documented gallstones or polyps by imaging.

 -  Body Mass Index (BMI) < 45 kg/m2.

 Exclusion Criteria:

 -  Any female patient, who is pregnant, suspected pregnant, or lactating.

 -  Any patient with acute or acalculous cholecystitis.

 -  Any patient with an American Society of Anesthesiologists Score > 3.

 -  Any patient who is undergoing Peritoneal Dialysis (PD).

 -  Patients who are taking immunosuppressive medications or are immunocompromised.

 -  Patients on blood thinners or aspirin or abnormal blood coagulation tests.

 -  Patients who have a history of prior open abdominal surgery or prior transvaginal
 surgery.

 -  Patients with a history of ectopic pregnancy, pelvic inflammatory disease (PID) or
 severe endometriosis.

 -  Non English speaking patients.