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In what may be the first procedure of its kind in the United States, surgeons removed a woman's gallbladder without making a single external incision. Performed at New York-Presbyterian Hospital/Columbia University Medical Center, the procedure was performed by inserting an endoscope through a 1-inch incision in the uterus. The 3-hour outpatient procedure was performed to treat gallstones.


According to lead surgeon Marc Bessler, MD, internal incisions in the uterus are less painful and heal faster than abdominal incisions made during traditional gallbladder surgery. Called NOTES (natural-orifice translumenal surgery), the new procedure is also being offered for appendectomy, abdominal exploration, and biopsy by Dr. Bessler's team.

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At present, the only approach used for NOTES is through the uterus, but the team plans to develop alternative approaches through the rectum or mouth.