Something interesting I have learned about in the past week weeks I natural orifice surgery. I saw an article about a woman who had her appendix removed through her vagina. This reminded me of surgeries they use to do in ancient times. The way natural orifice surgery works is the surgeon operates on the body through natural openings such as the mouth, vagina, rectum, and urethra. By doing this the surgeon doesn’t have to cut the skin which can lead to infections and complications. Only around 1,000 patients in Europe, Britain, and America have undergone this surgery. Hopefully more people will undergo this surgery in order to see if it has benefits over traditional surgery.
Surgeons have already used natural orifice surgery to remove prostates, kidneys, appendices, gallbladders; it can even be used to perform weight loss surgery. Surgeon Kurt Robert of Yale University performed the first appendectomy (appendix removal) in 2008. The surgery was less than an hour and half and the woman had no visible scars. Dr. Mitchell Humphreys of the Mayo Clinic removed the prostate of one man in 2010 and so far has had no signs of complications. Dr. Vikram Reddy a assistant professor of surgery at Yale University is experimenting with natural orifice surgery for patients with Crohn's disease (gastrointestinal). One other advantage to the surgery is that there is less of a chance of the patient of hernias. There however are risks associated with this procedure like any procedure. Since there is an internal incision usually made it can cause internal leaking from the incision made on the inside of the body.
There is no doubt natural orifice surgery is in its early stages. Hundreds if not thousands of surgeries will have to be performed in order to determine if this new type of surgery offers any benefits. What is fascinating is how surgeons use to have to make large and long cuts to perform surgery. Then in the 1980’s and early 1990’s surgeons started doing laparoscopic surgeries. Then in the early 2000’s robotic surgery was introduced. Perhaps natural orifice surgery will take off in the next ten years. Only time will tell.
The first transvaginal endoscopic appendectomy in a human was carried out in 1998 at the Mount Sinai Hospital of Queens by Dr. Tsin, et al utilizing rigid laparoscopic instruments and minimal abdominal assistance.( Operative Culdolaparoscopy: a novel approach combining operative culdoscopy and minilaparoscopy .J. Am Assoc.Gyn Laparoscop . 2001;8:438-441)
ReplyDeleteA transvaginal endoscopic cholecystectomy in a humans was carried out on August 20, 1999 at the Mount Sinai Hospital of Queens by Dr. Tsin et al. utilizing rigid laparoscopic instruments and minimal abdominal assistance. (Culdolaparoscopy , published in 2003 and Minilaparoscopy Assisted Natural Orifice Surgery , published in 2007)
ReplyDeleteI would point out the words "minimal abdominal assistance". The surgery was a precursor to NOTES even according to Dr. Tsin as this presentation shows http://www.slideshare.net/tsin/history-of-natural-orifice-transvaginal-endoscopic-surgery
ReplyDelete