New technology for painless and scarless surgery

Washington, May 20 : Scientists have come up with a new surgical technology that holds promise for a painless and scarless surgery with shorter recovery times than laparoscopic surgery.

The new study talks about the safety and efficacy of natural orifice translumenal endoscopic surgery (NOTESTM) that would soon make it possible for the doctors to perform painless and scarless surgeries in future.

"The research developments presented today are continuing to demonstrate the great potential of this exciting new surgical procedure," said Dr Pankaj J. Pasricha, FASGE, professor of medicine, gastroenterology and hepatology, Stanford University School of Medicine.

"Surgical advances like NOTES may lead the way toward the adoption of even more minimally invasive techniques than laparoscopy and allow patients to return to their home, family and work more quickly," he added.

NOTES is performed by passing an endoscope through a natural orifice then through an internal incision in the stomach, vagina, bladder or colon, thus avoiding any external incisions or scars.

The researchers have conducted the largest and controlled study of natural orifice surgery to date. The study showed that while NOTESTM is more time-consuming than traditional (laparoscopic) surgery, it is equally successful.

It also demonstrated that complex surgery with a high rate of complications could be performed via the mouth using a flexible endoscope.

During the study, with the help of NOTESTM the researchers for the first time looked at the entire uterus and reach areas that had not previously been accessible.

The findings are important because the morbidity and mortality of fetal surgery is substantial.

Using flexible endoscopy, doctors can reach almost any part of the uterus, regardless of the direction the fetus is facing. Furthermore, the procedure could be particularly helpful since it provides a minimally invasive approach to performing fetal surgery.

"Our findings suggest that NOTES may provide an avenue through which one can ultimately stage even more complicated operations in pregnant women and the fetus," said Dr Samuel A. Giday, assistant professor of medicine at Johns Hopkins University School of Medicine division of gastroenterology and hepatology.

In a randomized, multi-centre study of 30 pigs, investigators measured procedure time, recovery time and weight gain at days seven and 14. The study found that closure time using the endoscopic NOTES technique was significantly longer than with open surgery.

Researchers found that animals in the endoscopic group had significantly fewer lesions at autopsy, and recovered more quickly post-operatively, compared with open surgery.

Incisionless surgery using robotic technology, in which surgeons work exclusively through the mouth or other openings, showed excellent results in a recent study as it allowed patients to undergo procedures without pain and scarring, the procedure was performed on an outpatient basis and the robotic technology enabled doctors to perform procedures in ways they would not otherwise be able to do.

ANI