What's New
The Future of Surgery: No Scars in Sight
Marc Bessler, MD, Director, Minimal Access Surgery Center, and his colleagues at Columbia University Medical Center are using, testing, and refining three new methods of performing surgery that leave no external scars on the body.
Scarless Surgery Program Offers GERD Procedure
The Scarless Surgery Program at NewYork-Presbyterian Hospital/Columbia University Medical Center, directed by Drs. Marc Bessler and Peter Stevens, is now offering patients with severe, chronic acid reflux disease an incision-free procedure called TIF, or transoral incisionless fundoplication. The TIF procedure corrects reflux by repairing the faulty lower esophageal sphincter. The procedure is performed under general anesthesia and takes less than an hour. The clinician inserts a specially-designed device through the patient's mouth and into the stomach, just below the gastroesophageal junction, where tissue is molded to create a new valve. The announcement was picked up by Medical News Today.com.
Read the NewYork-Presbyterian Hospital press release.
A Single-Incision First
NYPH/Columbia's first single-port laparoscopic sleeve gastrectomy for morbid obesity was performed during fall of 2008. The sleeve gastrectomy is a procedure for surgical weight loss whereby approximately 85% of the stomach is removed, dramatically reducing the patient's capacity for food intake. This procedure is often performed laparoscopically through four or five small incisions; in this case, the surgeon used a specially designed laparoscope and instruments to complete the entire procedure through a single small incision. Other benefits of the single-incision procedure include less pain and quicker recovery. The patient had a smooth recovery.
Second Annual NOTES Course
The second annual NewYork-Presbyterian NOTES course drew close to 200 health professionals representing 20 states and 20 countries and five continents.
The ACCME-accredited event took place Dec. 15 and 16 at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and Rockefeller University.
The annual conference focuses on natural orifice endoscopic and translumenal techniques, often referred to collectively as scarless surgery.
The course was led by surgeons and physicians from Columbia University and Weill Cornell medical centers, including Columbia's Marc Bessler, MD and Peter Stevens, MD, who performed one of the first scarless gallbladder removals during 2008 and pioneered a laparoscopic-camera-assisted version of the procedure during 2007.
Use of the procedure is being expanded to include weigh loss surgery and abdominal operations including appendectomy.
The Future of Surgery
New center at Columbia performs abdominal procedures without external incisions
The promise of surgery without any external incisions is the wave of the future, thanks to pioneering work being done to perform surgeries through the body's natural orifices. In a new Columbia center dedicated solely to this work, the future is upon us. Surgeons and researchers at Columbia's new Center for Scarless Surgery are devoted to the advancement of procedures done through natural orifices of the body such as the mouth or the anus.
Scarless Surgery with Natural Orifice Techniques through an internal incision behind the uterus or in the stomach
Natural orifice translumenal endoscopic surgery, or NOTES, is a new method of performing minimally invasive surgery through the wall of an organ or internal cavity such as the rectum or behind the uterus (retro-uterine). Drs. Marc Bessler, Peter Stevens and Dennis Fowler successfully performed the first U.S. retro-uterine gall bladder removal operation (cholecystectomy) with limited laparoscopic assistance as part of a larger IRB approved study.
In addition to retro-uterine removal of the gallbladder, the Columbia team is conducting minimally invasive procedures for appendectomy, gastroesophageal reflux, and weight loss surgery.
Read more.
Columbia Scarless Surgery Press Coverage
- December, 2007: NewYork-Presbyterian/Columbia Conducts NOTES Conference
On December 18, 2007, Crain's Health Pulse healthcare newsletter ran an article highlighting the NewYork-Presbyterian/Columbia NOTES conference, which was held December 10-11, 2007 and attracted nearly 200 people from eight countries. The Crain's article also mentioned the first U.S. retro-uterine cholecystectomy, performed in March by Marc Bessler, MD, Dennis L. Fowler, MD, and Peter Stevens, MD.
Read the NewYork-Presbyterian Hospital press release regarding the NOTES conference.
On July 9, 2008, The Toronto Star View ran an article and surgical video of the Columbia procedure. View article and video on the Toronto Star Website. - First U.S. Retro-uterine Gallbladder Removal, Performed by Columbia Surgeons
An April 20, 2007 New York Times article about the surgical technique natural orifice translumenal endoscopic surgery, or NOTES, featured a retro-uterine gall bladder removal operation performed on a 66-year-old-woman by Drs. Marc Bessler, Peter Stevens and Dennis Fowler on March 20, 2007. The operation was the first of its kind in the U.S. The groundbreaking operation was also featured in United Press International (April 20) and ABCNews.com (April 23), and was mentioned in a May 8 New York Newsday article about NOTES procedures.
Selected Columbia Faculty Publications on Scarless Surgery
- Herron DM, Birkett DH, Thompson CC, Bessler M, Swanström LL. Gastric bypass pouch and stoma reduction using a transoral endoscopic anchor placement system: A feasibility study. Surg Endosc. 2007 Nov 20; [Epub ahead of print] Visit pubmed to search article title and view article.
- Bessler M, Stevens PD, Milone L, Parikh M, Fowler D. Transvaginal laparoscopically-assisted, endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. Gastrointestinal Endosc. 2007, Sept 22. Visit pubmed to search article title and view article.
- Bessler M, Stevens DP, Milone L, Hogle N, Durak E, Fowler D. Transvaginal Endoscopic Cholecystectomy: Laparoscopically assisted. Accepted for publication on Surgical Endoscopy.
- Bessler M, Stevens PD, Milone L, Fowler D. An endosurgical operating system: initial human experience in endolumenal and NOTES procedures. Accepted for presentation at SAGES 2008.
Columbia Surgeons Who Helped Pioneer Revolutionary Technique Present International Course on NOTES Surgery
One of First Courses to Address Advanced Minimally Invasive Surgical Techniques for Access to Internal Organs Through Existing Body Openings
What may be the first international medical education course on the advanced minimally invasive technique called NOTES—natural-orifice translumenal endoscopic surgery—was presented at Columbia and Cornell Weill medical centers by the surgeons who helped pioneer the revolutionary technique on December 10-11, 2007.
The procedure, which allows for minimally invasive surgical access to internal organs through existing body openings.
The ACCME-accredited course attracted worldwide attention, with close to 200 attendees representing eight nations, including the United States, Argentina, Brazil, Ecuador, France, Greece, Italy and Japan.
