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Surgeons Remove Gallbladder Through Vagina


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When the doctors saw the woman 10 days later, she was back to normal and had no bleeding, discharge or discomfort, according to the report.

"It is exciting to contemplate the potential for natural orifice transluminal endoscopic surgery in improving patient care," the researchers wrote. "A surgical intervention that eradicates the need for any incision, avoiding bodily trauma, is attractive to patients and also has an aura that surgeons find hard to resist."

But Ren thinks the basic premise of this type of surgery -- called natural orifice transluminal endoscopic surgery -- is misguided. "I admire the surgeons for their innovation and forward-thinking. However, the basic philosophy is backwards," she said.

Text Continues Below



One of the basic principles of surgery is to avoid injury to internal organs, because, even if they are repaired, there still is an inherent risk of the repair tearing apart, Ren said. "If this happens, serious infection can occur which occasionally is fatal. In this paper, the vaginal wall is purposely injured and therefore opens the possibility for more serious complications," she said.

The standard way of removing a gallbladder -- laparoscopically -- is safer than doing it through an open cut, Ren said. The advantage that natural orifice transluminal endoscopic surgery provides -- which the French researchers call "scarless" and "less painful" -- is negligible when compared to the scars and pain that patients experience after non-laparoscopically performed surgeries, she said.

In addition, the operation through the vagina takes three to four times longer than it takes to perform laparoscopically, increasing the risk to patients who need more anesthesia, Ren noted.

Roberts is concerned that doctors may try to perform the procedure without the proper training.

"Until the procedure becomes common, it should be restricted to academic settings and to trained surgeons," he said. "It takes doing a number of procedures before surgeons become proficient."

More information

For more on gallbladder surgery, visit the U.S. National Library of Medicine.

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Copyright © 2007 ScoutNews, LLC. All rights reserved.
Last updated 10/17/2007

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SOURCES: Kurt E. Roberts, M.D., assistant professor of gastroenterology, Department of Surgery, Yale University School of Medicine, New Haven, Conn.; Christine Ren, M.D., assistant professor of surgery, New York University School of Medicine, New York City; September 2007, Archives of Surgery


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