Transvaginal natural orifice translumenal endoscopic surgery (NOTES): a survey of women’s views on a new technique

Strickland, Andrew; Norwood, Michael; Behnia-Willison, Fariba; Olakkengil, Santosh A.; Hewett, Peter

doi:10.1007/s00464-010-0968-3

Cited by 60 publications

(52 citation statements)

References 18 publications

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“…On the other hand, the safety profile of surgical procedures was considered to be of vital importance; in our sample, the risk of complications was considered the most important aspect of a surgical procedure by nearly 90% of patients. This result is in line with other published surveys [7,8,21,22]. In a recent paper [23] on 420 subjects, the most important concern regarding surgical therapy was the fear of surgical complication, with 92% placing it first, whereas postoperative scars were the first concern for only 2% of the participants.…”

Section: Discussionsupporting

confidence: 79%

“…Peterson et al [8] reported that in 100 women asked for NOTES cholecystectomy 73% would consider a trans-vaginal procedure, and 68% indicated that if the data show equivalency between laparoscopic and trans-vaginal procedures, they would prefer the latter approach. On the other hand, in another recent paper [22], observational data from 300 women revealed that 75% were indifferent or sceptical towards the NOTES technique for cholecystectomy, even if the two approaches (NOTES and laparoscopy) were defined as similar in outcome. In Rao et al [9], a hypothetical scenario was given in which the respondent presents as an emergency in a hospital requiring an appendectomy.…”

Section: Discussionmentioning

confidence: 99%

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Obese Women’s Perception of Bariatric Trans-vaginal NOTES

et al. 2011

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Much of the discussion pertaining to natural orifice transluminal endoscopic surgery (NOTES) focuses on technical issues, with little attention to women's perception and to their willingness to consent to this surgery, especially in the field of obesity. Aim of this study was to evaluate obese women's perception of NOTES and trans-vaginal access. Sixty two obese patients undergoing bariatric surgery were given a written description of NOTES with an anonymous questionnaire exploring their concerns and opinions regarding this technique. The risk of complications was the most important aspect with regard to surgical procedures for 87.1% of patients, while the aesthetic result counted only for 16.1%; none of the patients would accept an increased risk of surgical complications for a better aesthetic result, and 74.2% of them would prefer a standardized traditional surgical approach. Nulliparous women were more concerned about the potentially negative effects of NOTES on fertility than multiparous women and younger women were more worried about the effects on sexual function than older women. 83.9% of patients refusing NOTES stated that the main reason for their refusal was the lack of definitive data on the beneficial effects. Bariatric NOTES potentially offers obese women a scarless intervention, but only a few obese women expressed worries about the cosmetic/aesthetic effects of surgery, while most of them were worried about effects on future fertility and sexual life. Our study highlights a strong need for early reporting of outcome data to enlighten patients about this new approach to bariatric surgery.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

et al. 2011

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“…Interestingly, three-fourths of the women surveyed were neutral or unhappy about the prospect of a NOTES procedure, even it was stipulated that laparoscopy and NOTES had equivalent safety and efficacy. The effect of NOTES on sexual function was expressed as a particular concern by younger women [76]. In another report, Peterson et al surveyed 100 women, exploring their concerns and opinions regarding transvaginal surgery [77].…”

Section: 4mentioning

confidence: 99%

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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LESS Natural orifice transluminal endoscopic surgery NOTES Robotics UrologyPlease visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been developed to benefit patients by enabling surgeons to perform scarless surgery. Objective: To summarize and critically analyze the available evidence on the current status and future perspectives of LESS and NOTES in urology. Evidence acquisition: A comprehensive electronic literature search was conducted in June 2010 using the Medline database to identify all publications relating to NOTES and LESS in urology. Evidence synthesis: In urology, NOTES has been completed experimentally via transgastric, transvaginal, transcolonic, and transvesical routes. Initial clinical experience has shown that NOTES urologic surgery using currently available instruments is indeed possible. Nevertheless, because of the immaturity of the instrumentation, early cases have demanded high technical virtuosity. LESS can safely and effectively be performed in a variety of urologic settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low, mostly being small case series or casecontrol studies from selected centers. Thus, the only objective benefit of LESS remains the improved cosmetic outcome. Prospective, randomized studies are largely awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technology advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics is likely to drive a major paradigm shift in the development of LESS and NOTES. Conclusions: NOTES is still an investigational approach in urology. LESS has proven to be immediately applicable in the clinical field, being safe and feasible in the hands of experienced laparoscopic surgeons. Development of instrumentation and application of robotic technology are expected to define the actual role of these techniques in minimally invasive urologic surgery.

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“…Postoperative intercourse abstinence after transvaginal NOTES elicited worry in 76% of responders. As previously reported, 18 concerns related to sexual function and fertility must be taken into account when dealing with a female population.…”

Section: Notes Versus Less: Comparative Analysismentioning

confidence: 99%

“…18 In their study, 300 individuals were surveyed, including 195 health professionals, 37 patients who were undergoing or had recently undergone laparoscopic cholecystectomy, and 68 gynecologic clinic patients. The results suggested that the compelling incentive for NOTES, namely the absence of abdominal scars, might not be such an important factor for many patients.…”

Section: Comment Which Patients Would Prefer Notes and Why?mentioning

confidence: 99%

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

Autorino

White

Gettman

et al. 2012

Urology

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Evidence relating to the perception and view of patients and physicians on natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) was scrutinized. A comprehensive literature search was performed through PubMed. A total of 18 studies were included in the analysis. Patients demonstrated interest in scarless surgery, with a preference for LESS over NOTES. Safety and efficacy remain the key factors in the decision-making process of patients. With more information about the safety and reproducibility of LESS and NOTES, and with improved educational efforts, patients and physicians alike may feel more comfortable in widespread application of scarless surgery. UROLOGY 80: 495-502, 2012.

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Transvaginal natural orifice translumenal endoscopic surgery (NOTES): a survey of women’s views on a new technique

Cited by 60 publications

References 18 publications

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

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