Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Women's Health

Font Size

Natural Orifice Surgery: No Scars

Surgery Without External Cuts Called 'Next Greatest Surgical Evolution'
WebMD Health News
Reviewed by Louise Chang, MD

Sept. 17, 2007 - French doctors who report removing a woman's gallbladder through her vagina say such "no-scar surgery" may be the wave of the future.

At least two U.S. women -- one at New York Presbyterian Hospital and another at the University of California San Diego Medical Center -- have undergone similar surgeries.

Doctors who advocate the technique call it "natural orifice transluminal endoscopic surgery" or NOTES. "Natural orifice" here means the vagina, the anus, or the mouth. "Transluminal" means surgeons insert surgical tools (endoscopic tools) through the body's natural openings. And the "surgery" part means doctors still have to cut through to the inside of the body and to operate on diseased organs.

The idea is to eliminate big incisions -- and surgical scars -- and to speed recovery after surgery.

Jacques Marescaux, MD, and colleagues at Louis Pasteur University in Strasbourg, France, appear to have been the first to perform NOTES surgery without backup from the laparoscopic instruments used for conventional minimally invasive surgery.

"With its invisible mending and tremendous potential for improving patient care and well-being, NOTES might represent the next greatest surgical evolution," Marescaux and colleagues suggest.

The surgeons report details of the operation in the September issue of Archives of Surgery.

Fast Recovery After Natural Orifice Surgery

Marescaux and colleagues performed the NOTES gallbladder removal on a 30-year-old woman with gallstones. The surgeons used endoscopic tools inserted through the woman's vagina during general anesthesia.

To reach the gallbladder, the surgeons made a small incision at the rear of the woman's vagina. The only external incision was a tiny cut in the woman's abdomen to insert a needle scope (the cut was also used to inflate the abdominal cavity with gas and to aid in removal of the gallbladder). The gallbladder was removed through the vagina.

On the evening after surgery, the woman felt well enough to go home. Because she was their first NOTES patient, her doctors kept her overnight and she left the hospital the next morning. Ten days later, the woman had resumed full activity with no discomfort, discharge, or bleeding.

Doctors developing the NOTES technique say similar operations could be done by mouth. However, this would mean making a cut in the stomach or gut to get to internal organs. Research continues on the best way to make sure these cuts can be closed without risk of leakage.

A group of surgeons has formed the Natural Orifice Surgery Consortium for Assessment and Research -- NOSCAR -- to promote NOTES research and responsible use of the technique. The group hopes to develop better techniques and better medical tools for NOTES surgeries.

Today on WebMD

hands on abdomen
Test your knowledge.
womans hand on abdomen
Are you ready for baby?
birth control pills
Learn about your options.
Is it menopause or something else?
woman in bathtub
bp app on smartwatch and phone
estrogen gene

Send yourself a link to download the app.

Loading ...

Please wait...

This feature is temporarily unavailable. Please try again later.


Now check your email account on your mobile phone to download your new app.

Blood pressure check
hot water bottle on stomach
Attractive young woman standing in front of mirror