Earlier this month I wrote a story about natural orifice surgeries — removing organs through the mouth and vagina — taking place at the University of California, San Diego Medical Center.

Earlier this year, a team of renowned surgeons at the university’s Center for the Future of Surgery was the first in the nation to remove an appendix through the mouth and an appendix through the vagina. This month, the same team of surgeons performed the nation’s first gastrectomy — a partial removal of the stomach for weight loss — through the vagina.

Roughly 200,000 patients in the United States undergo traditional gastrectomy surgery each year. The nascent technique, however, was performed with only two millimeter-sized external incisions instead of the five incisions required by the traditional procedure, resulting in fewer scars.

“Our goal is to continually expand surgery options using emerging technology so that patients experience less pain and better outcomes,” said Dr. Mark Talamini, chair of surgery at the UCSD Medical Center, in a release.

Officially known as the sleeve gastrectomy, the weight-loss surgery removes 80 percent of the stomach so that the patient feels full after eating less, takes in fewer calories and loses weight.

Here’s how the 75-minute procedure was performed using the natural orifice technique; one incision was placed in the belly button through which a camera was inserted to view the abdomen. The second incision was placed just below the sternum to insert an instrument to retract the liver.

The partial stomach removal was then performed by using a tube-like tool to go through the vagina and making a small interior incision behind the uterus through which the abdomen and stomach could be accessed with surgical tools. The stomach was reduced in size with surgical staplers and the excess stomach was pulled down through the abdomen and out of the vagina.

The patient, a 29-year-old Escondido woman, said she suffered from polio as a child which caused permanent disability in her leg and chronic pain, preventing her from exercising regularly. She is 5-feet tall and weighed 253 pounds before the surgery, according to UCSD.

UCSD surgeons said such minimally invasive techniques hold promise for other future surgeries, including treatments such as tumor removals for cancers.


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