Incisionless surgery holds great promise, specialists say

Surgeons in the Department of Surgery at Ohio State University Medical Center are the first in the country to use a new surgical technique for abdominal procedures that could be one of the next major medical advancements in the United States.

The experimental technique, called natural orifice translumenal endoscopic surgery, holds considerable promise, say surgeons, who are using the mouth to gain access to the abdominal cavity, instead of cutting through the outside of the body.

The technique leaves no outside scarring, results in no postoperative pain, and may reduce patients’ recovery times.

Dr. Jeffrey W. Hazey

“This is a first clinical step in the U.S. toward developing an incisionless and painless technique for abdominal surgery,” says Dr. Jeffrey W. Hazey, assistant professor of surgery in the Division of General and Gastrointestinal Surgery and a specialist in interventional endoscopy.

At Ohio State, the procedure is being performed in conjunction with more traditional operative techniques for diagnosing abdominal malignancies and cancer staging.

To reach the abdominal cavity, a flexible endoscopy tube encasing a fiber-optic camera and remote-controlled surgical cutting tools is inserted through the mouth. Once the tube reaches the stomach, the wall of the stomach is pierced, and the tube is advanced into the abdominal cavity, where the surgical tools can be used to perform delicate procedures.

When a procedure has been completed, the tube is withdrawn through the hole in the stomach, and the puncture is closed. Hazey says the technique may be adapted for other procedures in the body by using other natural entry points.

Dr. W. Scott Melvin

Hazey and Dr. W. Scott Melvin, professor of surgery, chief of the Division of General and Gastrointestinal Surgery, and director of Ohio State’s Center for Minimally Invasive Surgery, are the first surgeons in the United States to use the new technique in clinical abdominal procedures. The technique has been used clinically in India to perform appendectomies and tubal ligations.

With additional testing and refinement, Melvin says natural orifice translumenal endoscopic surgery could become commonplace. “As with any new technology, there are many steps to take before it can be adopted for widespread use, but there is certainly a lot of excitement about this technique among surgeons.”