Surgeons Remove Appendix Through Patient's Mouth

March 19, 2008 — -- Scientists are moving closer to developing the techniques and the technology that could someday allow surgeons to perform many operations without cutting the skin.

Sound far-fetched? Not according to researchers at the University of California, San Diego, who removed a patient's appendix a few days ago by pulling it out through his mouth.

That was a bit of a milestone, since it had never been done in this country before, although surgeons in India performed the same operation in 2005 using different technology.

The work is still in its infancy, and research is being conducted at a number of institutions. The goal, at this stage, is to determine if the procedure is safe, and if patients benefit from having no surface incisions.

"The question is do patients do better or not?" said Santiago Horgan, professor and director of the Center for the Future of Surgery at UC San Diego's Medical Center.

Horgan was part of a surgical team that removed the diseased appendix of a patient, Jeff Scholz, 42, on March 12 through his mouth. In a telephone interview, Horgan emphasized that the procedure is still in the trial phase, and it will be years before the technique becomes routine, if ever.

In a statement issued by the university, Mark A. Talamini, chair of the department of surgery, described the research as "groundbreaking."

"As far as I know, this is the first time an appendectomy has been done in this country using this technique," Jeffrey Hazey, a general surgeon specializing in minimally invasive surgery at the Ohio State University Medical Center, said in an e-mail.

The research is pushing the boundaries of laparoscopic surgery, a minimally invasive technique that leaves fewer and smaller scars by inserting a camera and surgical instruments through a very small incision.

"Through laparoscopic surgery we learned that by minimizing the number of incisions, and going from a seven or eight inch incision to a one inch incision, patients improved in terms of hospital stay, complications of the wounds, post operative hernia, pain, and so forth," Horgan said.