For the first time in Canada, McGill University Health Centre (MUHC) surgeons have performed a completely incisionless and scarless surgery. The procedure is performed endoscopically through a natural body orifice, considerably reducing pain, recovery time and complications. Doctors at the MUHC used this procedure to significantly reduce the symptoms for two patients suffering from a rare swallowing disorder called Achalasia.
Invented by Japanese surgeon, Dr. Haru Inoue, the procedure is one type of a grouping of minimally invasive surgeries known as NOTES, or Natural Orifice Translumenal Endoscopic Surgeries. In these surgeries, a flexible endoscope and accessory instruments are inserted through a natural body orifice and passed through the wall of an organ to reach the area requiring intervention.
“The surgery completely eliminates the need for incisions,” says Dr. Melina Vassiliou, Assistant Professor of Medicine at McGill University and McGill University Health Centre Surgeon. “This means there are no wounds, which is good news for the patient because there may be less wound complications, less risk of infection, less pain, and a faster recovery time compared to laparoscopic surgical approaches.”
Achalasia affects about 1 in every 100,000 people. The most common symptom of achalasia is difficulty swallowing solids and liquids. Other symptoms can include chest pain, regurgitation of swallowed food and liquid, heartburn, and associated issues such as apnea and weight loss. The cause is unknown and there is no cure. There are other treatment options to control symptoms of achalasia, but up until now, laparoscopic surgery has been shown to provide the best, long-term results. We do not know how the NOTES procedure will compare to the laparoscopic surgery, but this will be the next question to investigate once the procedure is proven to be safe and effective in the short term.