• Taking out the gallbladder via the vaginal route

    From lasergyn@gmail.com@21:1/5 to All on Fri Jun 9 14:54:41 2017
    The report of a transvaginal cholecystectomy (TVC) performed on August 20, 1999 at Mount Sinai Hospital of Queens, New York, was published in 2003 under the name of Culdolaparoscopy ( before the acronym NOTES) . Since then, several groups have
    described different modifications of the vaginal port and by using rigid or flexible endoscopes with different levels of laparoscopic assistance and TVC without abdominal ports

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  • From lasergyn@gmail.com@21:1/5 to Donna on Fri Jun 9 14:55:06 2017
    On Thursday, April 19, 2007 at 10:56:41 PM UTC-4, Donna wrote:
    Creepy

    Doctors Try New Surgery for Gallbladder Removal

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    Article Tools Sponsored By
    By DENISE GRADY
    Published: April 20, 2007

    Doctors in New York have removed a woman’s gallbladder with instruments passed through her vagina, a technique they hope will cause less pain and scarring than the usual operation, and allow a quicker recovery. The technique can eliminate the need to cut through abdominal muscles, a
    major source of pain after surgery.

    The operation was experimental, part of a study that is being done to
    find out whether people will fare better if abdominal surgery is
    performed through natural openings in the body rather than cuts in the belly. The surgery still requires cutting, through the wall of the
    vagina, stomach or colon, but doctors say it should hurt less because
    those tissues are far less sensitive than the abdominal muscles.

    Interest in this idea heightened after doctors from India made a video in 2004 showing an appendix being taken out through a patient’s mouth. The patient had abdominal scars that would have made conventional surgery difficult.

    The New York patient, 66, had her gallbladder removed on March 21 and is recovering well, said her surgeon, Dr. Marc Bessler, the director of laparoscopic surgery at Columbia University Medical Center. Dr. Bessler
    said he thought it was the first time the operation had been performed in the United States, and he plans to show a video of the operation at a gastroenterology meeting in Las Vegas on Sunday.

    “Going through a natural orifice, the mouth or rectum or vagina, to get into the abdomen and do an operation, is being excitedly worked on by a whole lot of people,” Dr. Bessler said, adding that companies were beginning to make special surgical tools for the operations and that
    doctors had formed an organization called Noscar (www.Noscar.org), which stands for Natural Orifice Surgery Consortium for Assessment and
    Research.

    The idea is part of a broader trend to make surgery less and less
    invasive. In the late 1980s and early ’90s, surgeons began removing gallbladders with laparoscopic surgery, performed through a few small
    slits in the belly for a camera and surgical tools instead of the 10-inch incision needed for the original, open operation. Although some doctors
    were skeptical at first about the laparoscopic approach, it soon caught
    on, and now accounts for 90 percent of gallbladder operations.

    “But patients still have pain, recovery time and scars,” Dr. Bessler said. “The next phase to make it better is to eliminate the remaining causes of pain — incisions and instruments that have to go through the muscles of the abdominal wall.”

    Surgeons not involved in the research had mixed reactions.

    Dr. Christine Ren, an associate professor of surgery at New York University’s school of medicine, called the vaginal procedure “repulsive”
    and said: “As a woman I find it very invasive, physically and
    emotionally. To me it’s quite distasteful. You will really have to prove to me that there is a benefit.”

    Dr. Ren questioned whether women would accept it, and pointed out that
    even though conventional laparoscopic surgery required cutting through
    the belly, it had an excellent safety record and patients recovered
    quickly. She said the idea of puncturing internal organs and then sewing them up was cause for concern.

    But she also said, “I give them a lot of credit for trying new things.”

    Dr. Walter E. Longo, a professor of surgery at Yale, said that the
    technique was “extremely experimental” and that there was no information yet about whether it would work as well or be as safe as conventional laparoscopic surgery. If the natural-orifice approach is to gain
    acceptance, it will have to measure up to the standard technique in a
    study, he said.

    Dr. Longo also said he thought the new technique would be limited to relatively small operations like taking out the gallbladder or appendix,
    or exploring the abdomen to assess pain or determine the stage of a
    cancer.

    “I think we’re all sort of waiting to see how safe it is and how it’s accepted, and above all to make sure it doesn’t do any harm to patients,”
    Dr. Longo said.

    At Stanford, Dr. Myriam J. Curet, a professor of surgery, said, “It has some promise, and there’s a lot of interest in the surgical community, a lot of attention being paid to it as a wave of the future.”

    Dr. Curet acknowledged that the idea was a bit disturbing at first, and
    said that even an audience of doctors shuddered at the video of the
    appendix being pulled out through the patient’s mouth. But if the
    recovery does turn out to be quicker and less painful than the current methods allow, patients might want the procedure, including women in whom
    it would be performed vaginally.

    Dr. Bessler said his patient agreed to the procedure (two others had declined) because he told her he thought it would have advantages for
    her, and she accepted his judgment. She was the first in a study that is
    to include 100 women who need gallbladder surgery, appendectomies or biopsies taken from inside the abdomen. All the procedures will be done through the vagina.

    Dr. Dennis Fowler, another surgeon who participated in the operation,
    said the team began experimenting on women because “incisions in the vagina have been used for a variety of procedures for decades, and proved safe with no long-term consequences.”

    Dr. Bessler said he and his colleagues had been doing practice operations
    in the laboratory on pigs for the past year, removing gallbladders,
    spleens, kidneys and stomachs through the mouth or vagina.

    Eventually, Dr. Bessler said, he expects to use the natural-opening technique on men as well as women, with instruments passed down the
    throat or into the rectum to cut through the wall of the stomach or intestine to reach the gallbladder or other organs. But first, surgeons
    have to develop techniques to make sure that the cuts in the stomach and intestine can be sealed completely after the operation so that they do
    not leak into the abdomen, which could cause serious complications. Incisions through the wall of the vagina rarely cause leaks, he said.

    Cutting through the wall of the vagina is safe even for women who may
    want to have children later, because scarring would not interfere with
    labor or birth, Dr. Bessler said. The vaginal incision in the surgery
    last month was about an inch long, which was large enough to allow the gallbladder to be removed.

    The operation took about three hours, twice as long as the usual laparoscopic surgery, but it was the team’s first operation on a human, and the time should decrease with practice, Dr. Bessler said. Also
    because it was the first time, to be on the safe side, the doctors did
    make three small openings in the abdomen for surgical tools. But their ultimate goal is to perform the operation entirely through the vagina.


    http://www.nytimes.com/2007/04/20/health/20surgery.html?_r=2 &hp&oref=slogin&oref=slogin

    --
    ~Donna
    http://www.frugalsewing.com

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  • From lasergyn@gmail.com@21:1/5 to Donna on Fri Jun 9 14:56:32 2017
    On Thursday, April 19, 2007 at 10:56:41 PM UTC-4, Donna wrote:
    Creepy

    Doctors Try New Surgery for Gallbladder Removal

    * Sign In to E-Mail or Save This
    * Print
    * Reprints
    * Share
    o Digg
    o Facebook
    o Newsvine
    o Permalink

    Article Tools Sponsored By
    By DENISE GRADY
    Published: April 20, 2007

    Doctors in New York have removed a woman’s gallbladder with instruments passed through her vagina, a technique they hope will cause less pain and scarring than the usual operation, and allow a quicker recovery. The technique can eliminate the need to cut through abdominal muscles, a
    major source of pain after surgery.

    The operation was experimental, part of a study that is being done to
    find out whether people will fare better if abdominal surgery is
    performed through natural openings in the body rather than cuts in the belly. The surgery still requires cutting, through the wall of the
    vagina, stomach or colon, but doctors say it should hurt less because
    those tissues are far less sensitive than the abdominal muscles.

    Interest in this idea heightened after doctors from India made a video in 2004 showing an appendix being taken out through a patient’s mouth. The patient had abdominal scars that would have made conventional surgery difficult.

    The New York patient, 66, had her gallbladder removed on March 21 and is recovering well, said her surgeon, Dr. Marc Bessler, the director of laparoscopic surgery at Columbia University Medical Center. Dr. Bessler
    said he thought it was the first time the operation had been performed in the United States, and he plans to show a video of the operation at a gastroenterology meeting in Las Vegas on Sunday.

    “Going through a natural orifice, the mouth or rectum or vagina, to get into the abdomen and do an operation, is being excitedly worked on by a whole lot of people,” Dr. Bessler said, adding that companies were beginning to make special surgical tools for the operations and that
    doctors had formed an organization called Noscar (www.Noscar.org), which stands for Natural Orifice Surgery Consortium for Assessment and
    Research.

    The idea is part of a broader trend to make surgery less and less
    invasive. In the late 1980s and early ’90s, surgeons began removing gallbladders with laparoscopic surgery, performed through a few small
    slits in the belly for a camera and surgical tools instead of the 10-inch incision needed for the original, open operation. Although some doctors
    were skeptical at first about the laparoscopic approach, it soon caught
    on, and now accounts for 90 percent of gallbladder operations.

    “But patients still have pain, recovery time and scars,” Dr. Bessler said. “The next phase to make it better is to eliminate the remaining causes of pain — incisions and instruments that have to go through the muscles of the abdominal wall.”

    Surgeons not involved in the research had mixed reactions.

    Dr. Christine Ren, an associate professor of surgery at New York University’s school of medicine, called the vaginal procedure “repulsive”
    and said: “As a woman I find it very invasive, physically and
    emotionally. To me it’s quite distasteful. You will really have to prove to me that there is a benefit.”

    Dr. Ren questioned whether women would accept it, and pointed out that
    even though conventional laparoscopic surgery required cutting through
    the belly, it had an excellent safety record and patients recovered
    quickly. She said the idea of puncturing internal organs and then sewing them up was cause for concern.

    But she also said, “I give them a lot of credit for trying new things.”

    Dr. Walter E. Longo, a professor of surgery at Yale, said that the
    technique was “extremely experimental” and that there was no information yet about whether it would work as well or be as safe as conventional laparoscopic surgery. If the natural-orifice approach is to gain
    acceptance, it will have to measure up to the standard technique in a
    study, he said.

    Dr. Longo also said he thought the new technique would be limited to relatively small operations like taking out the gallbladder or appendix,
    or exploring the abdomen to assess pain or determine the stage of a
    cancer.

    “I think we’re all sort of waiting to see how safe it is and how it’s accepted, and above all to make sure it doesn’t do any harm to patients,”
    Dr. Longo said.

    At Stanford, Dr. Myriam J. Curet, a professor of surgery, said, “It has some promise, and there’s a lot of interest in the surgical community, a lot of attention being paid to it as a wave of the future.”

    Dr. Curet acknowledged that the idea was a bit disturbing at first, and
    said that even an audience of doctors shuddered at the video of the
    appendix being pulled out through the patient’s mouth. But if the
    recovery does turn out to be quicker and less painful than the current methods allow, patients might want the procedure, including women in whom
    it would be performed vaginally.

    Dr. Bessler said his patient agreed to the procedure (two others had declined) because he told her he thought it would have advantages for
    her, and she accepted his judgment. She was the first in a study that is
    to include 100 women who need gallbladder surgery, appendectomies or biopsies taken from inside the abdomen. All the procedures will be done through the vagina.

    Dr. Dennis Fowler, another surgeon who participated in the operation,
    said the team began experimenting on women because “incisions in the vagina have been used for a variety of procedures for decades, and proved safe with no long-term consequences.”

    Dr. Bessler said he and his colleagues had been doing practice operations
    in the laboratory on pigs for the past year, removing gallbladders,
    spleens, kidneys and stomachs through the mouth or vagina.

    Eventually, Dr. Bessler said, he expects to use the natural-opening technique on men as well as women, with instruments passed down the
    throat or into the rectum to cut through the wall of the stomach or intestine to reach the gallbladder or other organs. But first, surgeons
    have to develop techniques to make sure that the cuts in the stomach and intestine can be sealed completely after the operation so that they do
    not leak into the abdomen, which could cause serious complications. Incisions through the wall of the vagina rarely cause leaks, he said.

    Cutting through the wall of the vagina is safe even for women who may
    want to have children later, because scarring would not interfere with
    labor or birth, Dr. Bessler said. The vaginal incision in the surgery
    last month was about an inch long, which was large enough to allow the gallbladder to be removed.

    The operation took about three hours, twice as long as the usual laparoscopic surgery, but it was the team’s first operation on a human, and the time should decrease with practice, Dr. Bessler said. Also
    because it was the first time, to be on the safe side, the doctors did
    make three small openings in the abdomen for surgical tools. But their ultimate goal is to perform the operation entirely through the vagina.


    http://www.nytimes.com/2007/04/20/health/20surgery.html?_r=2 &hp&oref=slogin&oref=slogin

    --
    ~Donna
    http://www.frugalsewing.com

    --- SoupGate-Win32 v1.05
    * Origin: fsxNet Usenet Gateway (21:1/5)