Doctors remove woman's gallbladder through her vagina

Apr 22 2007

In what must be a first surgeons have removed a woman's gallbladder from her body through her vagina.

By using a new technique called Natural Orifice Translumenal Endoscopic Surgery (NOTES) the team at NewYork-Presbyterian/Columbia University Medical Center passed a surgical instrument called an endoscope through the patient's vaginal wall and into her body cavity.

The flexible endoscope with some help from abdominally-inserted laparoscopic instruments, was then used to detach the gallbladder which was then sutured and then removed it via the vagina.

Until now NOTES has been mainly confined to treating conditions within the gastrointestinal tract.

The new technique promises reduced pain and scarring than is usually experienced and a faster recovery period.

The patient a 66-year-old woman who underwent the surgery on March 21st is apparently recovering well according to surgeon Dr. Marc Bessler, the director of laparoscopic surgery at the hospital.

Such surgery is still experimental and part of a larger study examining whether performing abdominal surgery through natural openings in the body instead of cutting open the patient's stomach will offer more positive outcomes.

Dr. Bessler says advances in minimally invasive surgical techniques over the last 15 years have dramatically reduced the number of open abdominal surgeries necessary and they eliminate a great deal of the associated discomfort.

Bessler says this latest advance of abdominal surgery through a natural orifice represents the culmination of this progression, and it means smaller and fewer skin incisions are needed.

In the future, says Dr. Bessler, some abdominal surgeries will be possible without any external incisions.

As well as gall bladder surgery, the NOTES technique is appropriate for appendectomy, abdominal exploration and biopsies.

The team consisted of Dr. Marc Bessler, Dr. Dennis L. Fowler (vice president and medical director for perioperative services at NewYork-Presbyterian/Columbia and the United States Surgical Professor of Clinical Surgery at Columbia University College of Physicians and Surgeons) and Dr. Peter D. Stevens (director of endoscopy at NewYork-Presbyterian/Columbia and assistant professor of medicine at Columbia University College of Physicians and Surgeons).

The surgeons presented their work at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) in Las Vegas on the weekend.