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"NOTES holds the potential to not only mitigate the pain and discomfortassociated with traditional procedures, but may eventually reduce a patient'srecovery time to as little as one day by eliminating incisions through thenerve-filled abdominal wall," said Nathaniel Soper, MD, the NorthwesternMemorial surgeon who together with colleagues Eric Hungness, MD and JohnMartin, MD, a surgeon and gastroenterologist respectively, performed theprocedure August 31.
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Soper, who is also the Loyal and Edith Professor and Chair of Surgery atNorthwestern University's Feinberg School of Medicine, says factorscontributing to the growing interest in incisionless surgery include the factthat the stomach and GI tract have very few nerves that register pain. In thefuture this may allow surgeons to carry out NOTES procedures with the patientunder sedation, rather than general anesthesia. The natural orifice techniquemay also help eliminate the risk of post-operative wound infections orhernias.
"This evolutionary step towards an incisionless surgical technique couldreduce costs, speed recovery and reduce pain," adds Hungness who is alsoAssistant Professor of Surgery at the Feinberg School. "I see incisionlessapproaches applying to a wide range of procedures in the future."
Martin, Director of Endoscopy and Associate Professor of Medicine andSurgery at the Feinberg School, explains that physicians have beenconceptualizing natural orifice surgery for years, but current endoscopicdevices do not offer a platform for it. By utilizing a stable operatingplatform, instruments can be manipulated to view, cut, grasp, and suturetissue without ever cutting into the skin, which may be attractive to somepatients as these procedures can eliminate all visible scars, and eliminatemuch of the pain that may occur in abdominal surgery involving skin incisions.
Medical devices that were utilized for this procedure included theEndoSurgical Operating System(TM) by USGI Medical and endoscopic equipmentmade by Olympus(TM). For this case, three small laparoscopic ports were usedin conjunction with the endoscopic system in order to assess the safety of theprocedure and to assist in refining the technique. Current risks includeproper suturing of the incision that is created in the stomach, as if notclosed properly, complications could occur. The team expects to graduallyeliminate these external ports in future procedures.
About Northwestern Memorial Hospital
Northwestern Memorial Hospital is one of the country's premier academicmedical centers and is the primary teaching hospital of the NorthwesternUniversity Feinberg School of Medicine. Northwestern Memorial and itsPrentice Women's Hospital and Stone Institute of Psychiatry have 744 bedsalong with 1,424 affiliated physicians and 6,464 employees. NorthwesternMemorial is recognized for providing state-of-the-art patient care andexemplary clinical and surgical advancements in the areas of cardiothoracicand vascular care, gastroenterology, neurology and neurosurgery, oncology,organ and bone marrow transplantation, and women's health.
Northwestern Memorial received the prestigious 2005 National QualityHealth Care Award and is listed in eight specialties in U.S. News & WorldReport's 2007 rankings for "America's Best Hospitals." For seven yearsrunning, Northwestern Memorial has been rated among the nation's "100 Be
