High NOTES

The June 9 edition of The Economist contains an article on NOTES -- natural-orifice translumenal endosurgery. "Rather than operating on the abdomen by making incisions in the skin, it involves passing flexible instruments through the body's orifices and reentering the abdomen from the inside" (e.g., through a hole in the stomach). The article states that the potential benefits go well beyond not leaving a scar, including reducing the risk of post-operative infection and avoiding a general anaesthetic. Also, post-operative pain would be reduced because the stomach wall has relatively few pain receptors, so shorter recovery periods are possible.

Because entry would likely be through one hole, as opposed to several holes employed in external laparoscopic surgery, new techniques and equipment will be required for NOTES. This is stimulating a lot of inventiveness and new patents.

The trick, of course, will be to develop this clever approach to surgery in a way that achieves the hoped-for medical results without incorporating yet another increase in costs for our health care system.

Maybe the big national insurance companies should volunteer to be joint-venture partners with the surgical companies to help make sure both goals are met. That would end this story on a high note indeed.