Human applications of Natural Orifice Transluminal Endoscopic Surgery (NOTES) are still limited. Most of the cases are performed by hybrid procedures with laparoscopic assistance. Avoiding complications from incisions is the main objective for NOTES. In this lecture, Dr. Ricardo Zorron reports a technique developed in his institution, i.e., the use of two endoscopes inserted into the vagina to perform a Totally NOTES (T-NOTES) transvaginal cholecystectomy. He presents his experience and describes the preliminary results of a Multicenter Study.