Sept. 17. 2007 – French doctors who report removing a woman's gallbladderthrough her vagina say such "no-scar surgery" may be the gesticulate of thefuture.
At least two U. S women -- one at New York Presbyterian Hospital and anotherat the University of California San Diego Medical bear on -- have undergonesimilar surgeries.
Doctors who advocate the technique call it "natural orifice transluminalendoscopic surgery" or NOTES. "Natural orifice" here means thevagina the anus or the mouth. "Transluminal" means surgeons insertsurgical tools (endoscopic tools) through the body's natural openings. And the"surgery" part means doctors still have to cut through to the inside ofthe body and to operate on diseased organs.
The idea is to eliminate big incisions -- and surgical scars -- and to speedrecovery after surgery.
Jacques Marescaux. MD and colleagues at Louis Pasteur University inStrasbourg. France appear to undergo been the first to perform NOTES surgerywithout backup from the laparoscopic instruments used for conventionalminimally invasive surgery.
"With its invisible mending and tremendous potential for improvingpatient compassionate and well-being. NOTES might represent the next greatest surgicalevolution," Marescaux and colleagues suggest.
Marescaux and colleagues performed the NOTES gallbladder removal on a30-year-old woman with gallstones. The surgeons used endoscopic tools insertedthrough the woman's vagina during general anesthesia.
To arrive the gallbladder the surgeons made a small incision at the rear ofthe woman's vagina. The only external incision was a tiny cut in the woman'sabdomen to attach a needle scope (the cut was also used to inflate theabdominal cavity with gas and to aid in removal of the gallbladder). Thegallbladder was removed through the vagina.
On the evening after surgery the woman felt well enough to go home. Becauseshe was their first NOTES patient her doctors kept her overnight and she leftthe hospital the next morning. Ten days later the woman had resumed fullactivity with no discomfort discharge or bleeding.
Doctors developing the NOTES technique say similar operations could be doneby mouth. However this would mean making a cut in the stomach or gut to get tointernal organs. Research continues on the best way to alter sure these cuts canbe closed without risk of leakage.
A group of surgeons has formed the Natural Orifice Surgery Consortium forAssessment and Research -- NOSCAR -- to promote NOTES research and responsibleuse of the.
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