Orifice Alert!!! Use of natural openings may ease weight-loss surgery
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http://www.cnn.com/2009/HEALTH/02/06/orifice.surgery/index.html
In the fight against obesity, doctors have deployed stern warnings, dieting tips, liposuction and open-incision bariatric surgery. But some surgeons have found another avenue for weight loss.Surgeons at UCSD have reduced the stomach size of two women by going through the vagina.
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A handful of surgeons are using natural orifices -- such as the mouth or the vagina -- to perform bariatric surgery, which reduces stomach size.
Surgical instruments and a tiny camera travel through the patients' natural body openings to reach the desired organ in the procedure, known as natural orifice translumenal endoscopic surgery. In the bariatric procedure, the surgeon trims the stomach to a smaller size or stitches a slight pouch in it to make the patient feel full after a modest meal.
"Perhaps to some people, physicians and patients alike, it looks strange and unusual," said Dr. John Morton, director of bariatric surgery and surgical quality at Stanford University School of Medicine in Stanford, California. "I think from a female perspective, there's a natural apprehension in terms of having surgery done through [the vagina]."
Because no incisions are made through the external skin, the surgery reduces risks of infection, is less painful and leaves no scars, proponents say.
"We're trying to make a surgery that can minimize trauma," said Dr. Santiago Horgan, director of the University of California at San Diego Center for the Future of Surgery and Center for the Treatment of Obesity.
So far, American doctors have removed gallbladders, a kidney and appendixes through vaginas, pulled appendixes through mouths and repaired a hernia transvaginally. These surgeries are part of clinical trials and not used in general practice.
Horgan and doctors at UCSD have done about 50 natural orifice procedures-- 34 of them have been transvaginal gallbladder removals. Two of the procedures were gastrectomies, where 70 percent of patients' stomachs were removed through the vagina.
