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Obesity Surgery and Natural Orifices

Scalpel-free obesity surgery on the horizon

CLEVELAND, Ohio (Reuters) — Stomach-stapling surgery to combat obesity may be done in the future with a tube inserted through the mouth, making the procedure safer than using an incision and opening the way for more people to undergo it, doctors say.

Doctors have performed about 1 million bariatric surgeries worldwide, in which the stomach is stapled to make it smaller so people eat less, and some experts say it’s the best method to lose weight and keep it off.

Doing the surgery without incisions will make it a lower-risk, lower-cost proposition and may be applicable to patients who are less obese than those who are currently considered for surgery, said Dr. Philip Schauer, head of bariatric surgery at the Cleveland Clinic, which is hosting a three-day meeting on obesity.

The advent of laparoscopic surgery, also known as “keyhole” surgery, revolutionized all surgical procedures. It boosted demand for bariatric surgery in particular in the 1990s because it requires only a few small incisions, improving recovery time.

“I believe we are perhaps on the verge of another revolution,” said Schauer, who was recently named president of the American Society of Bariatric Surgery.

Natural orifice transendoscopic surgery, or NOTE, requires no incisions because instruments — such as long tubes with robotic arms and staple guns — can be inserted through the mouth and snaked down the esophagus.

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