Spinal anaesthesia for a NOTES (Natural Orifice Transluminal Endoscopic Surgery) total hysterectomy in a pre-lung transplant patient : a case report

We describe the first case of a vaginal NOTES total hysterectomy under spinal anesthesia in the head- down position without sedation or additive analgesia in a patient with end-stage COPD. This report adds to the growing evidence that neuraxial techniques are a good alternative for general anesthesia in select cases for laparoscopic surgery.