The First Surgeon to Remove a Gallbladder Via the
Mouth Joins Virtual Ports
Natural-Orifice Translumenal Endoscopic Surgery (NOTES) is an
innovative method of abdominal surgery that does not involve an
incision in the abdominal wall.
In the 1980s, a method of abdominal surgery was developed that does not require
large incisions in the abdominal wall; instead, a camera and surgical instruments are
inserted through tiny channels. This method, known as laparoscopy, is a kind of
minimally invasive or endoscopic surgery.
Laparoscopic surgery, in which doctors insert surgical instruments into the
abdominal cavity through orifices, revolutionized abdominal surgery and made recovery
much quicker than with open (regular) surgery. Some 5 million laparoscopic procedures
are now performed around the world each year.
Natural-orifice translumenal endoscopic surgery (NOTES) is an innovative method
of abdominal surgery that does not involve an incision in the abdominal wall. The
operation is performed through natural orifices such as the mouth. The surgeon passes the
camera and surgical instruments into the stomach and, from there, into the abdominal
cavity through an incision in the stomach lining. The entire operation uses only one
channel (as opposed to several channels in laparoscopic surgery), and is therefore
extremely challenging for surgeons.
NOTES is another step forward in abdominal surgery. Its advantages are obvious:
faster recovery, no scarring or unaesthetic marring of the abdominal wall, and less pain
(the incision is in the stomach lining, which is less sensitive than the stomach muscles).
In the future it may even be possible to perform the operations under sedation rather than
Some people believe that this innovative technique is currently where laparoscopy
was 20 years ago, and that in the future more and more operations will be done without
incisions in the abdominal wall.
Virtual Ports, Ltd. (http://www.virtual-ports.com), which specializes in developing
instruments for laparoscopic surgery in the abdominal cavity, reported this week that Dr.
Lee Swanstrom has joined the company’s scientific advisory board. Dr. Swanstrom,
director of minimally invasive surgery at Legacy Medical Center in Portland, Oregon, is
one of the developers of the NOTES technique. Last June he performed the first
gallbladder removal from a human being via the mouth without an incision in the
According to Dr. Swanstrom, the Virtual Ports retraction system is needed in
NOTES. Especially important is the EndoGrabTM device developed by Virtual Ports for
retracting internal organs for laparoscopic procedures. The device will make procedures
easier for surgeons and will offer them new opportunities for the challenging NOTES
EndoGrab was invented by Virtual Ports for use in laparoscopic surgery and received
FDA clearance for marketing earlier this year. The company plans to produce a version
of the instrument for NOTES operations as well.
The CEO of Virtual Ports, Udi Gordin, reports that the company is pleased to have
the opportunity to work with Dr. Swanstrom in this constitutive period for the NOTES
technology and to be involved in the creation and development of new, advanced surgical
techniques that are less dangerous and present substantial advantages to patients.
About Dr. Lee Swanstrom
Dr. Swanstrom is head of the surgery department at Legacy Emanuel and Good
Samaritan hospitals in Portland, Oregon. His primary clinical focus is the development of
advanced laparoscopic procedures. Dr. Swanstrom has published more than 40 papers
and edited three books, and he is a world renowned researcher and innovator in the field
of minimally invasive surgery.
For further information, please contact:
Nir Frider, Galil Communications