Pioneer of Natural Orifice Transluminal Endoscopic Surgery says the procedure will gain wider acceptance

Most of the surgeries one day would be done without any incision, said Dr. Anthony N. Kalloo, pioneer of NOTES, a technique to perform an abdominal operation without incisions using an endoscope.

NOTES (Natural Orifice Transluminal Endoscopic Surgery) was first carried out in animal models by Dr. Anthony in 1999.

The maiden operation in humans was done by Chairman of Asian Institute of Gastroenterology (AIG), Dr. D. Nageshwar Reddy and his colleague Dr. G. V. Rao in 2003. Since then, NOTES was used to conduct more than 3,000 surgeries in Europe, USA and South America.

Talking to The Hindu, Dr. Anthony, who is Professor of Gastroenterology and Director, Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, USA, said that 100 years from now there would not be any incision for any kind of surgery. “We are already evolving into less and less incisions,” he added.

He said NOTES was now being used by veterinarians to remove ovaries (oophorectomy) in horses.

He said that although NOTES was being used for removal of gall bladder and appendix, bariatric surgeons were adopting the technique in the United States and South America.

Explaining its advantages, he said that patients would have no scar and recover faster. In Brazil and Los Angeles, California, the procedure became quite popular among young women as they do not want a scar on the abdomen during removal of gall bladder. He said that generally gall bladder disease was more common in women, especially the young and middle-aged and a lot of it had to with the hormonal differences.

In most cases, the gall bladder would be removed because of the pain or due to formation of gall stones. Over 90 per cent of patients get better after gall bladder removal and nearly half a million gall bladder surgeries were being done each year in the United States.

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