N.O.T.E.S. = Natural Orifice Transluminal Endoscopic Surgery

Right after the publication of a report of transvaginal cholecystectomy by a team of New York doctors, an independant team of surgeons in France published videos of Operation Anubis.

On April 2nd 2007, at the University Hospital of Strasbourg, Professor Jacques Marescaux and his team, B. Dallemagne, MD, S. Perretta, MD, D. Mutter, MD, PhD, FACS, A. Wattiez, MD, D. Coumaros, MD, successfully performed the first no scar surgery. This first human incisionless operation was carried out using a flexible endoscope for transvaginal cholecystectomy in a 30-year-old woman with symptomatic gallstones.

The New York operation was carried out with laparoscopic ports in place in order to assist in case of problems with the NOTES. However, the French team performed the procedure completely scarless.

You can view the video of the procedure if you register in Websurg.

Another “kembang” moment!!!!!

The HOT MAMA Eastcoastlife appeared in an interview by Martin Lidsey on MartyBLOGs today.

And *drumroll* she names MOI as one of her frequent reads.. woohooo! I’m in cloud nine times nine liao

Perhaps a little bit of explanation about laparoscopy might be of interest to some readers… it seems that quite a number of you have had laparoscopic procedures before.

What is laparoscopy?

“Laparo-” means the abdominal cavity. Laparotomy means a procedure to open the abdominal cavity. Laparoscopy means insertion of a scope into the abdominal cavity.

How is it performed?

There’s are 2 major components, the camera system and the operating system. The camera system is the eye for the surgeon and the operating system is the one used to perform procedures on the tissues.

Here’s are some photos from an earlier post in publicinfo to show the set-up (”ports” are the short, hollow tubes that enter the abdomen to allow passage of the gas, camera and instruments):

Laparoscopy is the use of a laparoscope to perform an operation in the abdominal cavity via small incisions. It is part of a group of operations called minimal access surgery. It is the same operation as an open operation but done via small access points.

Among the benefits are less pain, smaller and more cosmetic scars, early discharge from hospital and early return to work or school, and less wound infection compared to open surgery. It has a longer learning curve (meaning takes longer to learn) than open surgery, though.

Laparoscopy is commonly performed nowadays for cholecystectomy and appendicectomy. There are a number of laparoscopic “guru”s who employ laparoscopy for many other operations. Some are not yet considered “mainline”, standard procedures, but if the surgeon knows his own capability, and the patient knows the limitations and is willing, then it is probably worth trying the laparoscopic approach.

Dr. John Thanakumar, from Vellore, India, is one such “guru”. He was in Penang on 12th to 13th April to demonstrate his method of doing some laparoscopic procedures at the Adventist Hospital. It was organised by Dr. Ansari, the paediatric surgeon, and I was glad to be one of those picking up pointers and gaining inspiration on how to improve our laparoscopy service to patients.

Want to see what a surgical live demonstration looks like?

OK.. it’s not my grasper. The management bought it. But I WAS THE FIRST ONE TO USE IT TODAY!!! Haha.. From Karl-Storz. I requested one that had longer limbs for more gentle grasping and a good rachet… PLUS this one has a good sturdy shaft and working mechanism… PLUS it’s easy to maintain and quite idiot-proof to clean.

Here it is… I know, I know … only the shiny business end of it is showing. It’s GRASPING something in the abdomen.

Good tools make light work.