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90th Annual Meeting Abstracts

Determining Opinions About Natural Orifice Transluminal Endoscopic Surgery
*Tamar L Mirensky, M.D.1, *Agata Gluszek, M.S.2, *Annette Roberts, B.A.2, *Andrew Duffy, M.D.1, Robert L Bell, M.D.1, *Priya A Jamidar, M.D.1, *Kurt E Roberts, M.D.1
1Yale New Haven Hospital, New Haven, CT;2Yale University, New Haven, CT

Objective: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an emerging technique within general surgery in which procedures are performed without skin incisions thru natural orifices such as the vagina, stomach or rectum. This study sought to evaluate the public’s understanding and preferences regarding NOTES.
Design: An electronic survey was conducted.
Setting: Single center study.
Patients: 115 health care employees voluntarily participated in an anonymous survey.
Interventions: N/A
Main Outcome Measure: Attitudes towards and preferences for NOTES.
Results: Survey respondents included 94 females (81.7%) with a mean age of 46 years. Education level and medical knowledge varied with the majority of participants trained as registered nurses. When asked about the impact of factors in deciding to undergo surgery, participants were most concerned about complications (importance rating 4.94/5) and least concerned about cosmesis (importance rating 3.47/5). Among available surgical techniques, 47.6% preferred laparoscopy, 27.4% NOTES, 2.4% open procedures, 0.8% had no preference and 21.8% remained undecided. Participants were more likely to undergo NOTES (44.3% vs 50.4%) if recommended by a physician with participants preferring transgastric or transvaginal routes rather than transrectal or transvesicular approaches. Only 17.4% of the respondents initially stated that they would not agree to undergo NOTES while 33.9% remained undecided and 3.5% did not answer the question. Participants were reluctant to undergo NOTES because of its novelty with unknown complications and limited physician experience but were more agreeable when considering faster return to work and routine activities.
Conclusion: NOTES is a promising technique in the field of general surgery. A more thorough understanding of the attitudes surrounding this technique will enable physicians to adequately address concerns and tailor techniques in response to patient preferences.


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