NOTES. Study on patients’ perspective

INTRODUCTION: 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. AIM: To evaluate patients’ opinions on the four surgical approaches: open, laparoscopic, transvaginal and transgastric. MATERIAL AND METHODS: For this purpose a special questionnaire was designed and one hundred randomly selected women were asked to complete it. RESULTS: The laparoscopic access was preferable in most aspects, closely followed by the transvaginal access. Open and transgastric approaches were considered as dangerous and disadvantageous. CONCLUSIONS: 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.