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NOTES: Weight Loss Surgery by Mouth

There are already several procedures available for weight loss surgery, but a new version of an old idea is now being performed by surgeons in the US.

Instead of having a single large, open incision in the belly to perform lap-band surgery for patients that need to lose weight fast, a new procedure makes use of just five small incisions along with a procedure via the mouth is now available that is much less painful, less invasive and has a high percentage of success.

What is NOTES?

The procedure that takes around an hour to perform is described as a kind of hybrid laparoscopic and NOTES (Natural Orifice Translumenal Endoscopic Surgery). School of Medicine surgeons at University of California in San Diego (UCSD) claim that they are the very first surgeons in the US to perform this procedure which involves reducing the working size of the stomach via the mouth.

The weight loss procedure known as sleeve gastrectomy is a novel one that reduces the effective size of the stomach to just 20 percent of its original size. Following this procedure, patients with an effectively smaller stomach experience increased feelings of fullness after eating small meals which leads to a lower caloric intake.

The director of UCSD Center for Treatment of Obesity, Santiago Horgan, MD said that their goal is to offer patients a long-term, customized weight loss solution with the minimum scaring possible.

What Does the Procedure Involve?

The procedure involves making 5 small incisions in the abdomen to partially remove the excess stomach and then to close the abdomen. The small incisions allowed surgeons to insert cameras and other instruments into the abdomen and for surgeons to close the stomach safely.

Trauma is minimized in the abdomen by the removal of excess stomach via the mouth. Horgan said that the absence of any large incision greatly reduces the risk of developing hernia and also greatly reduced pain for the patient. He believes that surgeons are getting closer to being able to perform weight loss surgery completely without scars.

Following the surgery, patients are reported to lose approximately 2 to 4 pounds per week.

NOTES has also been used in several other applications. Flexible surgical tools are used in this surgical technique as well as cameras that can easily pass through any natural orifice in the body. These include the mouth, anus, urethra, then through an incision made internally in the stomach, vagina, colon or bladder.

NOTES History:

June 2007: Dr. Lee Swanstrom performed the first human transgastric cholecystectomy

2008: Surgeons from Johns Hopkins School of Medicine using a procedure known as transvaginal donor kidney extraction successfully removed a healthy kidney from a female donor using NOTES

March 2008: Dr Horgan performed the first U.S. oral appendectomy

Dr Horgan has since performed over 100 NOTES procedures.

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Posted on Thu, 12 Aug 2010 in News | 0 Comments

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