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Incisonless surgery via mouth, vagina

CHICAGO, March 12 (UPI) -- Women who get gall bladder surgery through the vagina or the mouth had less pain and a quicker recovery time than others, U.S. researchers said.

Dr. Eric Hungness, a minimally invasive gastrointestinal surgeon and assistant professor of surgery for Northwestern Medicine, says Natural Orifice Translumenal Endoscopic Surgery, or incisonless surgery, works well for the stomach and GI tract because they have very few nerves that register pain.

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In the future, surgeons may be able to conduct NOTES procedures with the patient under sedation, rather than general anesthesia, Hungness says.

"Transvaginal surgery is one of the safest alternatives to traditional laparoscopic surgery because it uses an easily accessible natural orifice that has proven safe for over a century," Dr. Magdy Millad, director of gynecologic endoscopy and professor of obstetrics and gynecology for Northwestern Medicine, says in a statement.

To date, published NOTES cases include removal of the appendix and kidney and hernia repair. The optimal orifice for NOTES has not been determined but physicians say for women transvaginal access is the least complicated, Hungness says.

Male patients are limited to removal through the mouth, but transrectal access has recently been proposed as a potential alternative access route for men, Hungness says.

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