Sunday, June 17, 2012

Crohn’s Surgery Without Scars? Natural Orifice Surgery

Natural orifice surgery has been around for a couple of years now. The idea of natural orifice surgery is to remove organs through natural orifices (mouth, rectum, vagina, and urethra. This has an advantage over existing laparoscopic surgeries considering there is minimal cutting which reduces the risk of infection and complications. However, only 1,000 of these surgeries have been performed and although they are safe they haven’t been around long enough to show if they are more beneficial than existing methods. Sometimes I wonder if minimally invasive means it is a minimally effective. My guess is that natural orifice is safe as either an open or laparoscopic procedure and in time it will only get better and safer.

                The first procedure was performed by Kurt Roberts a surgeon at Yale University who took out an appendix in 2008. The surgery took less than an hour and half. I would point out that as surgeons do more of these surgeries they not only get better at them but also faster. Dr. Vikram Reddy a surgeon also at Yale University has performed a natural orifice surgery on a patient with ulcerative colitis. The patient had his entire colon and rectum removed with the largest incision being less than one inch. I emailed Dr. Reddy and asked him about the applications of this type of surgery on people with Crohn’s disease. According to Reddy he believes there might be a role depending on where the Crohn’s is located and how severe it is.

If natural orifice surgery was able to be shown to be both safe and effective for people with Crohn’s then it would be an improvement over the traditional approaches of an open surgery or laparoscopic procedure. However, much more research needs to be done on natural orifice surgery.  

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