Home E-Weekly April 30, 2007

Vaginal Cholecystectomy Impressive But Controversial

Published: October 10, 2007

In a video presentation delivered on the closing day of the Society of American Gastrointestinal and Endoscopic Surgeons' annual meeting in Las Vegas earlier this month, Marc Bessler, MD, demonstrated the removal of a 66-year-old female patient's gallbladder using a flexible endoscope passed through an incision in her vagina, which was then sutured.

During the presentation, Dr. Bessler, the director of Laparoscopic Surgery at New York Presbyterian Hospital, Columbia University Medical Center, promoted this "natural orifice" procedure as an example of the future of minimally invasive surgery.

"Internal incisions, such as in the vaginal wall, are less painful and may allow for quicker recovery than incisions in the abdominal wall," he says, noting that the patient whose procedure was depicted in the video presentation is recovering well.

Some proponents of this type of operation are considering its possibilities through the formation of the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR).

Others, however, question the safety of puncturing internal organs for surgical access. In published reports about the presentation, Christine Ren, MD, assistant professor of surgery at New York University Medical Center describes the procedure as "repulsive."

"As a woman, I find it invasive, physically and emotionally," she says. "To me it's quite distasteful."
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