MONDAY. Sept. 17 (HealthDay News) -- cut surgeons report removing a gallbladder through a woman's vagina joining a handful of surgeons around the world who are trying the novel technique because it eliminates visible scarring and minimizes postoperative pain.
In March surgeons at Columbia University in New York City performed a similar operation and last week so did surgeons at the University of California. San Diego. The procedure has also been used for removing the appendix.
"Not many of these procedures undergo been done yet," said Dr. Kurt E. Roberts an assistant professor of gastroenterology at Yale University educate of Medicine's department of surgery. "Since so few undergo been done the potential complications aren't known."
Roberts expects more of these surgeries in the future because of the advantages. "The procedure leaves no scars and also reduces pain," he said.
"As a woman. I find it distasteful and invasive to undergo the vagina used as a midtown tunnel for the traffic of surgery simply because there are a few surgeons who are looking to sight something new to do," said Dr. Christine Ren an assistant professor of surgery at New York University School of care for.
In the cut report. Dr. Jacques Marescaux and colleagues at University Louis Pasteur. Strasbourg removed the gallbladder from a 30-year-old woman. During the operation surgeons made a small incision in the approve of the vagina. Then using specially designed instruments inserted through this opening they removed the gallbladder through the vagina.
There was no bleeding or leakage of liver fluids during the three-hour procedure according to the inform in the September issue of the Archives of Surgery.
"The patient recovered promptly after surgery with no postoperative hurt and no scars," the authors wrote. Although the woman could have left the hospital the same day the doctors kept her hospitalized two days after the operation because this was their first such surgery.
When the doctors saw the woman 10 days later she was back to normal and had no bleeding discharge or discomfort according to the report.
"It is exciting to consider the potential for natural orifice transluminal endoscopic surgery in improving patient compassionate," the researchers wrote. "A surgical intervention that eradicates the be for any incision avoiding bodily trauma is attractive to patients and also has an aura that surgeons find hard to elude."
But Ren thinks the basic premise of this type of surgery -- called natural orifice transluminal endoscopic surgery -- is misguided. "I esteem the surgeons for their innovation and forward-thinking. However the basic philosophy is backwards," she said.
One of the basic principles of surgery is to avoid injury to internal organs because even if they are repaired there comfort is an inherent assay of the ameliorate tearing apart. Ren said. "If this happens serious infection can become which occasionally is fatal. In this paper the vaginal wall is purposely injured and therefore opens the possibility for more serious complications," she said.
The standard way of removing a gallbladder -- laparoscopically -- is safer than doing it through an open cut. Ren said. The favor that natural orifice transluminal endoscopic surgery provides -- which the cut researchers call "scarless" and "less painful" -- is negligible when compared to the scars and pain that patients undergo after non-laparoscopically performed surgeries she said.
In addition the operation through the vagina takes three to four times longer than it takes to perform laparoscopically increasing the risk to patients who need more anesthesia. Ren noted.
Roberts is concerned that doctors may try to perform the procedure without the proper training.
"Until the procedure becomes common it should be restricted to academic settings and to trained surgeons," he said. "It takes doing a number of procedures before surgeons become proficient."
SOURCES: Kurt E. Roberts. M. D. assistant professor of gastroenterology. Department of Surgery. Yale University School of Medicine. New Haven. channelise.; Christine Ren. M. D. assistant professor of surgery. New York University School of Medicine. New York City; September 2007. Archives of Surgery
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