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Z-shaped incision may drastically reduce invasive surgery

A new surgical technique, which allows doctors to operate on patients by making a Z-shaped incision inside the stomach might potentially replace certain types of conventional surgery in humans, say Penn State medical researchers.

Washington, Dec 18 : A new surgical technique, which allows doctors to operate on patients by making a Z-shaped incision inside the stomach might potentially replace certain types of conventional surgery in humans, say Penn State medical researchers.

The scientists came to the conclusion after successfully demonstrating the novel procedure in pigs.

The approach, known as NOTES (Natural Orifice Transluminal Endoscopic Surgery), involves using a natural opening in the body, in pig's case the mouth, to advance a flexible video endoscope into the stomach.

Using this tube, and the instruments contained within it, doctors currently make a small straight incision in the stomach to gain access to the abdominal cavity and the organs requiring attention.

"Theoretically, by eliminating body wall wounds with their associated complications and allowing some procedures to be done without general anaesthesia, this method could leave a truly minimal surgical footprint, and may even allow certain procedures to be done outside a traditional operating room," said Matthew Moyer, M.D., a gastroenterology fellow at Penn State Milton S. Hershey Medical Centre.

However, Moyer cautioned that NOTES is in the developmental phases and even a simple procedure might be fraught with potential complications at this point.

"One of those barriers is the closure of the access site. In other words, the opening made in the stomach must be reliably and safely sealed off at the end of the procedure," said Moyer.

The key to the researchers' approach lies in the way the flexible probe exits the stomach. Instead of cutting straight through the stomach wall the team guide the endoscope so that it first tunnels under the mucous membrane of the stomach wall for a while before exiting near an organ to be operated on. The endoscope essentially charts a Z-shaped path.

According to Moyer, this new technique, known as STAT (Self-approximating Transluminal Access Technique), has two main advantages, which include - there is significantly less bleeding involved and the Z-shaped tract effectively seals itself due to pressure created on the abdominal wall by normal breathing.

If the technique ultimately proves successful in human trials, researchers have said that it could circumvent the long painful recovery times and medical complications associated with surgery.

The findings are published in Gastrointestinal Endoscopy.

ANI