Sunday, January 18, 2009

Natural Orifice Surgery: A new development

Natural orifice transluminal endoscopic surgery (NOTES) is a new method of surgery where a natural orifice (mouth, urethra, anus, etc.) is used as a point of entry for insertion of surgical instruments, thereby avoiding external incisions or scars. The incision is made in the wall of the orifice to enter the site of the surgery.

This surgery was performed in 2004 for the first time anywhere in the world in India on humans; it was an appendectomy through the mouth. Its still experimental, but it was named one of the Top 10 medical innovations of 2009. CIMIT received several millions in grants to study this field in greater detail. Credit for inventing the surgery goes to Anthony Kalloo of Johns Hopkins University in Baltimore and Venkat Rao and Nageshwar Reddy of the Asian Institute of Gastroenterology in Hyderabad, India..

NOTES is attracting some criticism. Its not surprising. Every new development has people who takes sides. I remember when airbags first came out, Lee Iacocca argued against the technology in his book, saying airbags would go off without warning, creating more dangers than if we had them. Medical developments tend to attract greater sceptics.

Time will tell if NOTES goes mainstream or if it finds selected killer applications:

Robert Oliver

A US News article talked about a patient who had pain after the procedure in her mouth. See here

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