ASK DR. H: ‘No scar’ procedure shows promise

Q: What can you tell me about “no scar abdominal surgery?” Why aren’t more doctors doing it? – F.H., Huntsville, Ala.

A: The surgery you’re describing is not yet “ready for prime time,” although it definitely shows promise as an alternative to a number of laparoscopic and traditional abdominal surgeries. It’s called NOTES, an acronym for Natural Orifice Transluminal Endoscopic Surgery.

NOTES eliminates the need for traditional incisions and, for the right type of patient, results in much less painful surgery with a much more rapid recovery time. Two examples of NOTES surgery are a transvaginal appendectomy and a transvaginal cholecystectomy (gall bladder removal), where a small incision is made through the vaginal wall to gain access to the abdominal cavity and its organs. Each requires only two small incisions — one in the abdomen and one in the vagina.

Another surgical area where NOTES surgery holds tremendous promise is bariatric weight loss surgery. Imagine weight loss surgery without any incisions!

Incisionless transoral gastroplasty, for folks in need of moderate weight loss, involves placing a vacuum device down the throat and into the stomach to bring the sides of the stomach together to be stapled without any incisions. Another example of NOTES weight reduction surgery is transvaginal sleeve gastrectomy, where the vagina is used as a portal of entry to remove 70 percent of the stomach.

If shown to be safe and effective by the FDA, these NOTES procedures offer same day surgery options with a return to work and home activities within just a few days.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Because of the large volume of mail received, personal replies are not possible.

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December 4th, 2009
9:54 pm

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