Cakehole surgery

There was a report over the weekend that left me, um, speechless: it is apparently possible to have your appendix removed via your mouth.

Yes, I also struggle with the idea.

The procedure is referred to as Notes, which stands for natural orifice translumenal endosurgery.

The Notes procedure is said to cut trauma, hospital stays, risk of infection, complications and scarring. Briefly, it involves passing miniaturised flexible surgery tools and a camera through your mouth, and down into your stomach. (Yes, I know the appendix isn't in the stomach.)Then the surgeon makes an incision in the appropriate part of the stomach wall, passes the surgical tools onwards, and cuts the appendix free. It's then bagged and brought up, if you'll forgive the expression.

It's coming to a theatre near you: in the past few weeks, several separate surgical teams in different parts of the world claim to have successfully performed Notes.

If the idea of your organs ending up in your mouth is distasteful, there are other orifices that come in handy: in the US and France, different teams have done successful gall bladder removals via the vagina. I don't want to take this any further for now.

Conscious sedation can be used instead of general anaesthetic for Notes; and though there's an internal cut, the relative lack of nerve ends means recovery time is significantly shorter than it is even with keyhole surgery. You could, in fact, be back at work the same day, though perhaps with a sore throat.

It will be years before they offer it down at your local general hospital, but still, at the risk of sounding like my granny, isn't that something?

(Heather Parker, Health24, April 2008)