Introduction: The NOTES team (surgeon and gastroenterologist) at Baystate has extensive experience with animal work in developing novel techniques with commercially available products. Despite performing cholecystectomies in porcine models both through a transgastric and transvaginal approach, we have yet to perform a human case. The surgeons on the team have performed well over a thousand laparoscopic cholecystectomies; the gastroenterologist is a recognized advanced therapeutic endoscopist; and the gynecologist is an expert in transvaginal surgery. We believe that our combination of human experience and animal research will lead to safe attempts to perform the procedure described herein.