July 15, 2008 - Santiago Horgan, M.D., director of the UC San Diego Center for the Future of Surgery, used USGI Medicalï¿½s EndoSurgical Operating System (EOS) to demonstrate a technique that allows for appendectomy without abdominal incisions at the Natural Orifice Surgery Consortium for Assessment and Research's (NOSCAR) 3rd International Conference on Natural Orifice Translumenal Endoscopic Surgery (NOTES) on July 12.
Dr. Horgan removed a patientï¿½s appendix and fully closed the gastrotomy from inside the stomach in front of the meeting's 300 attendees. The ability to close the gastrotomy from inside the stomach is considered the major hurdle to the widespread adoption of incisionless NOTES surgery.
Dr. Horgan became the first surgeon in the U.S. to remove a patient's appendix through the mouth in late March, his 22nd "incisionless surgery" procedure. In later cases, he used USGI's EOS to close the gastrotomy through the patient's mouth following a NOTES appendectomy, reportedly another U.S. first.
"The ability to close a gastrotomy safely and securely from inside the stomach represents the major leap forward in Incisionless surgery and will enable us to perform truly scarless NOTES procedures," Dr. Horgan said. "Incisionless surgery technology has advanced significantly in recent years and we now have access to expandable tissue anchors that fit across the full thickness of the stomach wall and close the opening without a risk of leaks. With the EOS, we now have an operating platform for a wide variety of procedures."
During a NOTES procedure, surgical instruments are passed through one of the body's natural orifices, such as the mouth or vagina, to remove a diseased organ such as an appendix or gallbladder. Operating solely through the body's natural orifices eliminates external incisions and offers promise for less pain, shorter hospital stays, lower healthcare costs and no external scars compared to traditional and laparoscopic surgery.
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