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Natural Orifice Translumenal Endoscopic Surgery (NOTES): Patients’ Perceptions and Attitudes

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Abstract

Background

Natural orifice translumenal endoscopic surgery (NOTES) has generated a surge of enthusiasm among researchers by virtue of its challenge to the dogma and potential benefits. However, no data is available in the medical literature about NOTES' acceptance by patients in Asia. The aim of the study is to survey patients’ perceptions and attitudes towards NOTES.

Methods

It is a questionnaire-based multi-center study on inpatient subjects with various gastrointestinal disorders from 14 hospitals in 12 cities of China. Procedural details with the benefits and risks of NOTES, laparoscopic surgery, and conventional surgery were explained to all registered candidates. They were required to choose and cite reasons for adopting one of the above three surgical techniques as the preferred mode of treatment. The reasons for selection of the surgical treatment were: safety, efficacy, cost, postoperative pain, abdominal wounds, and scarring.

Results

There were 1,797 cases, including 976 (54.3%) males and 821 females (45.7%). Based on their comprehension of the procedure, 802 (44.6%) patients opted for NOTES, 757 (42.1%) for laparoscopic surgery, and 238 (13.2%) for conventional surgery. NOTES was mainly selected by the young and educated persons, especially females and by those with past exposure to laparoscopy or conventional surgery. The choice of treatment was significantly correlated with age (P = 0.0021), education (P = 0.0209), past medical history (laparoscopy, P = 0.0134; open surgery, P < 0.0001), and department of admission (P = 0.0173). The preference for NOTES was based on safety (37.3%), cost (17.6%), elimination of postoperative scars (16.1%), abdominal wounds (16.0%), and efficacy (13.1%).

Conclusions

The vast majority of patients prefer mini-invasive surgery to conventional surgery. The potential recipients of NOTES are educated and younger age groups. However, a few consider NOTES as a safe and effective intervention at present.

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Abbreviations

LS:

Laparoscopic surgery

CS:

Conventional surgery

NOTES:

Natural orifice translumenal endoscopic surgery

MIS:

Minimally invasive surgery

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Acknowledgments

This work was supported by a Technical Innovation Grant of the Chinese PLA General Hospital (No. 07CX202). We would like to thank Qurratulain Hyder for his English writing support.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, The Chinese People’s Liberation Army General Hospital, Fuxing Road 28, 100853, Beijing, China

    Wen Li, Zi-Kai Wang & Jian-Guo Xiao

  2. Department of Gastroenterology, The First Hospital of Jilin University, Changchun, China

    Hong Xu

  3. Digestive Medical Centre, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Zhi-Ning Fan

  4. Department of Gastroenterology, The Peoples Hospital of Xinjiang Municipality, Wulumuqi, China

    Shan-Duo Ba

  5. Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China

    Duo-Wu Zou

  6. Department of Gastroenterology, Heilongjiang Province Hospital, Harbin, China

    Xu Ren

  7. Endoscopy Center, Eastern Hepatobiliary Hospital of the Second Military Medical University, Shanghai, China

    Bing Hu

  8. Department of Gastroenterology, Peking University Third Hospital, Beijing, China

    Yong-Hui Huang

  9. Endoscopy Center, The First Affiliated Hospital of China Medical University, Shenyang, China

    Ming-Jun Sun

  10. Department of Digestive Diseases, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Jie Liu

  11. Department of Surgery, Tianjin Union Medical Center, Tianjin, China

    Wen Li

  12. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China

    Ping Xu

  13. Department of Gastroenterology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Qi Zhu

  14. Department of Gastroenterology, Nanfang Hospital of the Southern Medical University, Guangzhou, China

    Si-De Liu

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  1. Wen Li
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Correspondence to Wen Li.

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Li, W., Xu, H., Wang, ZK. et al. Natural Orifice Translumenal Endoscopic Surgery (NOTES): Patients’ Perceptions and Attitudes. Dig Dis Sci 56, 2415–2422 (2011). https://doi.org/10.1007/s10620-011-1797-5

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  • DOI: https://doi.org/10.1007/s10620-011-1797-5

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