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Surgery through natural orifices: some pros and cons

nose_frame.jpgEver since I assigned writer Sara Wykes to do a story on natural orifice surgery for the latest Stanford Medicine magazine, I've continued to come across new variations on the theme. Gallbladder removal by way of the mouth. Transvaginal kidney donation. Eye surgery through the nose (it's described at the link in the sidebar).

Sara started off writing the story as a serious skeptic. Her early reporting turned up concerns about the surgeries' steep learning curve, and frustrations over a lack of good tools.

So is this trend a good thing? Her reporting convinced me that this kind of surgery can be a great thing, at least when done by physicians with plenty of experience. In fact, in some cases, as with a man with a brain tumor described in Sara's story, it makes a treatment feasible.

No surgeon goes near the brain without a keen awareness of what inadvertent damage can do. The pituitary is one of the body’s master control organs, surrounded by critical neurological structures. Drilling a hole into Cherry’s skull was out of the question. Instead, Cherry’s tumor would be reached and removed through his nose.

Related: It's the pits: Turning surgery inside out, and Surgery without scars: Hospital pioneers natural orifice procedures

Illustration by Leif Parsons

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