1. Transvaginal laparoscopic cholecystectomy using a single port approach. Experimental and preliminary clinical cases Gerhard F. Buess University of Tuebingen

2. Transvaginal laparoscopic operation based on TEM 1994-1995 first culdoscopic hysterectomy and adnexectomy using TEM instruments Dr. Todorow, Bayreuth, Germany

3. Transabdominal laparoscopic surgery based on TEM beginning of the 1990s performance of cholecystectomies in different German hospitals

4. Drivers of change Goal of single port surgery R&D: flexible multifunctional devices with tools for diagnosis, surgical manipulation and application of drugs

5. Transvaginalcholecystectomy curved instruments

10. Rotation of shaft

11. Rotation of instrument tip

12. Design of an experimental prospective documented Trial Three surgeons, 30 cases each Subject A: Between 75 and 100 laparoscopic cholecystectomies experience Subjects B and C: Professors in surgery, well over 200 cholecystectomies, extensive experience in endoscopic surgery.

14. Time per procedure

15. P<0,05 * Groups of 15 cases * Learning curve by type of mistake * Minor mistakes Major mistakes Statistically significant

16. Transvaginal cholecystectomy with abdominal view on access - March 25th ’08

17. Transvaginal cholecystectomy - carcinoma - March 29th ’08

18. Transvaginal cholecystectomy - instrument rotation - March 26th ’08