Yonsei Med J.  2012 Sep;53(5):960-967.

Patient Perception of Natural Orifice Transluminal Endoscopic Surgery in an Endoscopy Screening Program in Korea

• Kim MC
• Kim KH
• Jang JS
• Kwon HC
• Kim BG
• Rattner DW

Abstract

PURPOSE
Natural orifice transluminal endoscopic surgery (NOTES) is a new method of accessing intracavitary organs in order to minimize pain by avoiding incisions in the body wall. The aim of this study is to determine patients' acceptance of NOTES in Korea and to compare their views about laparoscopic surgery and NOTES for benign and malignant diseases.
MATERIALS AND METHODS
The target number of total subjects was calculated to be 540. The subjects were classified into 18 sub-groups based on age groups, gender, and history of prior surgery. The questionnaire elicited information about demographic characteristics, medical check-ups, diseases, endoscopic and surgical histories, marital status and childbirth, the acceptance of NOTES, and the preferred routes for NOTES. In addition, the subjects chose laparoscopic surgery or NOTES for a hypothetical cholecystectomy and rectal cancer surgery, and responded to questions regarding the acceptable complication rate of NOTES, the appropriate cost of NOTES, and the reason(s) why they did not select NOTES.
RESULTS
486 of 540 patients (90.0%) who agreed to participate in this study completed the questionnaire. NOTES was preferred by the following patients: elderly; a history of treatment due to a disease; having regular check-ups; and a history of an endoscopic procedure (p<0.05). The most preferred route for NOTES was the stomach (67.1%). Eighty-four percent of the patients choosing NOTES responded that the complication rate of the new surgical method should be the same or lower than laparoscopic surgery. Vague anxiety over a new surgical method was the most common reason why NOTES was not selected in benign and malignant diseases (64% and 73%), respectively.
CONCLUSION
Patients appear to be interested in the potential benefits of NOTES and would embrace it if their concerns about safety are met. We believe that qualified surgical endoscopists can meet these safety concerns, and that NOTES development has the potential to flourish.

Keyword

NOTES; endoscopy; surgery; patient perception; survey

MeSH Terms

Aged
Anxiety
Cholecystectomy
Endoscopy*
Humans
Korea*
Laparoscopy
Marital Status
Mass Screening*
Methods
Natural Orifice Endoscopic Surgery*
Parturition
Rectal Neoplasms
Stomach

Figure

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  Fig. 1 Preference of route in NOTES. Among 486 patients who preferred NOTES, 326 patients (67.1%) chose transgastric approach for NOTES. NOTES, natural orifice transluminal endoscopic surgery.

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