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Tuesday, April 15, 2008

Look, no scars: organs removed via the mouth

THE minister charged with overhauling the NHS is testing a new form of scar-free surgery in which diseased organs are pulled out through the patient’s throat.

Professor Lord Darzi, chair of surgery at Imperial College London, has conducted preliminary experiments with the technique in which robotically controlled instruments are lowered into the patient’s stomach.

A hole is made in the lining of the stomach, then the organ - usually an appendix or gall bladder - is cut out and pulled up through the throat before the hole is stitched, leaving the patient with no external scars and a reduced risk of infection because the wounds are not exposed to the air.

The technique, called natural orifice translumenal endoscopic surgery, has been successfully used on patients in America, France and India. Darzi, who became a health minister last year, is one of the first surgeons in Britain to use the technique in experiments on pigs, before the first human tests.

While admitting it was still “early days”, Darzi believes the probe could eventually be used to remove cancers.

The main after-effects include a sore throat and an unpleasant taste in the mouth from having a diseased organ pulled through it.

Other orifices could be used but Darzi said he believed the mouth was the most promising. He said some aspects of the procedure needed perfecting.

“If we are going to enter through the stomach we need to develop the appropriate tools to make sure we can close the hole properly,” he said.

Darzi’s team are developing a new surgical robot called the iSnake, which they hope will assist in the new procedure and in keyhole surgery.

Other research projects on the new procedure are under way at hospitals around Britain. The first operations on patients in Britain are expected in three to four years.

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