Kobiela Jarek, Stefaniak Tomasz, Laski Dariusz, Mackowiak Malgorzata, Czurylo Alicja, Hac Stanislaw, Lachinski Andrzej J, Sledzinski Zbigniew
Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland.
Wideochir Inne Tech Maloinwazyjne. 2013 Sep;8(3):232-7. doi: 10.5114/wiitm.2011.34212. Epub 2013 Mar 26.
Rapid development of minimally invasive surgery has led to escalation of the demands placed on health care professionals. Nowadays the patient is the one to choose where and how she/he wants to be operated on. Perioperative and postoperative quality of life is the most common item impacting the patients' choice. Laparoscopic surgery is undoubtedly advantageous in several applications; however a further improvement of medical services has been introduced: the NOTES technique. This novel surgical approach definitively eliminates the problem of having scars. Though NOTES is still in the clinical trial stage, it might become an alternative for selected procedures soon. At this point it is necessary to define the patients' expectations and preferences.
To evaluate patients' opinions on the four surgical approaches: open, laparoscopic, transvaginal and transgastric.
For this purpose a special questionnaire was designed and one hundred randomly selected women were asked to complete it.
The laparoscopic access was preferable in most aspects, closely followed by the transvaginal access. Open and transgastric approaches were considered as dangerous and disadvantageous.
Currently NOTES is a possible reality of tomorrow for some procedures. The transvaginal access was scored as "attractive", "cosmetically attractive" and "technologically advanced", as opposed to the transgastric access. The fact of manipulation in the intimate region requires thorough attention in future NOTES studies. Though the patients currently prefer the laparoscopic approach, this study proves that further development of transvaginal NOTES technology is acceptable and to some extent desired by the patients.
微创手术的快速发展使得对医疗保健专业人员的要求不断提高。如今，患者可以选择在何处以及如何接受手术。围手术期和术后的生活质量是影响患者选择的最常见因素。腹腔镜手术在多个应用领域无疑具有优势；然而，医疗服务又有了进一步改进：NOTES技术。这种新颖的手术方法彻底消除了留下疤痕的问题。尽管NOTES仍处于临床试验阶段，但它可能很快成为某些特定手术的替代选择。此时，有必要明确患者的期望和偏好。
评估患者对四种手术方式的看法：开放手术、腹腔镜手术、经阴道手术和经胃手术。
为此设计了一份特殊问卷，并随机选取了100名女性要求她们填写。
在大多数方面，腹腔镜手术方式更受青睐，其次是经阴道手术方式。开放手术和经胃手术方式被认为危险且不利。
目前，对于某些手术来说，NOTES是未来可能实现的现实。与经胃手术方式相反，经阴道手术方式被评为“有吸引力”“在美容方面有吸引力”和“技术先进”。在私密区域进行操作这一事实在未来的NOTES研究中需要得到充分关注。尽管目前患者更喜欢腹腔镜手术方式，但这项研究证明经阴道NOTES技术的进一步发展是可以接受的，并且在某种程度上是患者所期望的。
