Digestive, Colorectal and Minimal Invasive Surgery Centre, Department of Surgery, University of Torino, C.so A.M. Dogliotti, 14-10126, Turin, Italy.
Obes Surg. 2012 Mar;22(3):452-9. doi: 10.1007/s11695-011-0578-8.
Much of the discussion pertaining to natural orifice transluminal endoscopic surgery (NOTES) focuses on technical issues, with little attention to women's perception and to their willingness to consent to this surgery, especially in the field of obesity. Aim of this study was to evaluate obese women's perception of NOTES and trans-vaginal access. Sixty two obese patients undergoing bariatric surgery were given a written description of NOTES with an anonymous questionnaire exploring their concerns and opinions regarding this technique. The risk of complications was the most important aspect with regard to surgical procedures for 87.1% of patients, while the aesthetic result counted only for 16.1%; none of the patients would accept an increased risk of surgical complications for a better aesthetic result, and 74.2% of them would prefer a standardized traditional surgical approach. Nulliparous women were more concerned about the potentially negative effects of NOTES on fertility than multiparous women and younger women were more worried about the effects on sexual function than older women. 83.9% of patients refusing NOTES stated that the main reason for their refusal was the lack of definitive data on the beneficial effects. Bariatric NOTES potentially offers obese women a scarless intervention, but only a few obese women expressed worries about the cosmetic/aesthetic effects of surgery, while most of them were worried about effects on future fertility and sexual life. Our study highlights a strong need for early reporting of outcome data to enlighten patients about this new approach to bariatric surgery.
大多数关于自然腔道内镜外科手术（NOTES）的讨论都集中在技术问题上，很少关注女性的感知和她们对这种手术的意愿，尤其是在肥胖领域。本研究旨在评估肥胖女性对NOTES 和经阴道入路的看法。我们向 62 名接受减重手术的肥胖患者提供了关于 NOTES 的书面描述，并通过匿名问卷调查了她们对该技术的担忧和意见。对于 87.1%的患者来说，手术并发症的风险是最重要的方面，而美容效果仅占 16.1%；没有患者愿意为了更好的美容效果而接受手术并发症风险的增加，74.2%的患者更愿意接受标准化的传统手术方法。未育的肥胖女性比已育的肥胖女性更担心NOTES 对生育能力的潜在负面影响，而年轻的肥胖女性比年长的肥胖女性更担心对性功能的影响。83.9%拒绝 NOTES 的患者表示，拒绝的主要原因是缺乏关于有益效果的明确数据。减重 NOTES 可能为肥胖女性提供一种无疤痕的干预措施，但只有少数肥胖女性对手术的美容/美观效果表示担忧，而大多数女性则担心对未来生育和性生活的影响。我们的研究强调了早期报告结果数据的强烈需求，以使患者了解这种新的减重手术方法。
