News | June 24, 2007

Oregon Surgeon Performs First U.S. Transgastric NOTES Gall Bladder Removal Surgery

June 25, 2007 – Dr. Lee Swanstrom, a surgeon at The Oregon Clinic, recently performed the first transgastric endoscopic cholecystectomy in the U.S. at Legacy Good Samaritan Hospital in Portland, OR, and since May has completed two additional procedures. The “no scar” surgery, or Natural Orifice Transluminal Endoscopic Surgery (NOTES), as it has become known, involves passing flexible surgical tools and a camera through the patient's mouth to reach the abdominal cavity by an incision made in the stomach. Removing the gall bladder without making traditional incisions on the surface of the skin is expected to result in less pain, lower risk of infection and reduce recovery time when compared to traditional surgery. At the end of the operation, the surgeon draws any removed tissue back through the patient’s mouth and seals the hole in the stomach. Dr Swanstrom's surgical team utilized the new EndoSurgical Operating System or EOS from USGI Medical Inc. to facilitate these procedures.
"These initial cholecystectomy procedures are an important first step in the development of methods and devices to enable the widespread adoption of incisionless NOTES surgery," said Dr. Swanstrom, director for The Oregon Clinic's Division of Gastrointestinal and Minimally Invasive Surgery (GMIS) and Director of Minimally Invasive Surgery at Legacy Health System. "In our first patients, we used two or three small laparoscopic ports to assess the safety of the procedure and to assist in the refinement of the technique. As we continue to gain experience, our protocol allows us to begin to eliminate these external ports."
"I am happy to begin transitioning our research to direct patient care. The success of this surgery will have very positive implications for patients," stated Dr. Swanstrom. "We hope it will reduce patient's recovery time due to the less invasive nature of this surgery, reduce their physical discomfort associated with traditional procedures, and leave them with no visible scarring following their surgery. Even with laparoscopic or "keyhole" surgery, patients stay off of work for several days, and have activity restrictions," he explained. "With NOTES they could potentially go back to work the next day."
"This is truly history-in-the-making," stated Dr. Lou Libby, Chief Medical Officer at The Oregon Clinic. "The results of this research study and this groundbreaking method will lay the foundation for conducting surgery more efficiently, reducing costs for the patient, provider and hospital."
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