Surgery Without the Scars

Sept. 20, 2007 — -- Doctors are stretching the boundaries of laparoscopic surgical technique, which involves inserting a light and a camera into the body, to develop new surgeries that leave few -- if any -- visible scars.

Instead of entering the body through the abdomen, which can leave scars, a dozen surgeons across the country have taken laparoscopic surgery to a new level -- the improved flexibility of the instruments allow them to go through the bellybutton.

The new technique, called single port access, has been used to remove all bladders, ovaries, uteruses, kidneys, spleens and appendixes. Doctors have also used the technique to repair hernias and colons.

"We've always been looking for something better, and as this developed over the past six months," Dr. Paul Crucillo at the Drexel University College of Medicine told ABC "World News." "I really think this is going to be the next step in minimally invasive surgery, and it's really something great to offer patients."

Other surgeons are more cautious.

"This is very interesting technology," said Dr. Thommaso Falcone at the Cleveland Clinic Foundation. "However, we have insufficient information to recommend to patients whether there are risks and benefits, which are different from traditional surgery."

Get the Details

To learn more about scarfree surgery, ABC News talked to Dr. Jeffery Hazey, a general surgeon specializing in minimally invasive surgery at the Ohio State University Medical Center.

ABC News: Why would someone choose to have scarfree surgery?

Hazey: From a patient's perspective, it is cosmetically beneficial. We are able to achieve the same results with little or no incision or pain, which is a major step forward in surgical care.

ABC News: For whom is this type of surgery recommended?

Hazey:: To date, incisionless surgery is used for three different applications. It is used for taking out the appendix, for taking out the gall bladder, and for diagnostic purposes -- to see if cancer in the abdomen has spread to other organs without having to cut the patient open. Surgeries are either transvaginal, which means removal through the vagina, or transgastric, which means removal through the mouth.

ABC News: Are these techniques any more dangerous than normal surgeries?

Hazey:: In skilled hands and for selected procedures, incisionless surgery is no more dangerous than laparoscopic or open surgery. However, we are still in the early stages of investigation.

ABC News: Are there any disadvantages to this type of surgery?

Hazey: One disadvantage right now is that the surgery is technically difficult. Without question, more research needs to be done before we can advance.

ABC News: How much pain do these operations cause? And how long does the healing process take compared to normal surgery methods?

Hazey: There would certainly be much less pain or potentially no pain at all -- that's the whole theory. This procedure also allows for a more rapid return to normal activities and to work.

ABC News: How much more does this type of surgery cost compared with conventional surgery?

Hazey: Right now, there is no financial remuneration. It is still too early to determine the cost difference.

ABC News: How long will it be before incisionless surgery becomes a routine standard of practice?

Hazey:I think we are a number of years away from incisionless surgery becoming routine. Three things need to happen. First, we need more investigation. Second, we need more training in how to perform the procedures. And third, we need to have improved technology and better instrumentation.

Right now, we are using prototypes that are not yet FDA approved. Once they become approved and companies develop better instruments, we can begin clinical trials. But all this takes time.

ABC News: What do you think the future of incisionless surgery will be?

Hazey: I think that with new technology, incisionless surgery will expand. To what? That's a good question. We wrestle with that in our meetings all the time. Some of the technology may be applied to bariatric procedures, which is surgery we do for weight loss.

ABC News: How important do you think these advances in incisionless surgery are?

Hazey: We in surgery are very excited. If you look at the evolution of surgery, the first revolution occurred when we did surgery by cutting people open, with very large incisions. In the '80s and '90s, we developed laparoscopic techniques that were minimally invasive. This was a second revolution.

We may be looking at the beginnings of a third revolution that involves making no incisions at all. It may take 10 to 20 years to come to fruition, but I believe we are on the cusp.