Surgeons go to new lengths to avoid scarring

PITTSBURGH, Pennsylvania (AP) -- A 4-year-old boy lay on an operating table in Pittsburgh a few weeks ago with a tumor that had eaten into his brain and the base of his skull. Standard surgery would involve cutting open his face, leaving an ugly scar and hindering his facial growth as he matured.

But doctors at the University of Pittsburgh Medical Center knew a way to avoid those devastating consequences. They removed much of the tumor through the boy's nose.

Since then, doctors in New York and in France have announced they removed gall bladders through the vaginas of two women. And doctors in India say they have performed appendectomies through the mouth.

It's a startling concept and a little unpleasant to contemplate. But researchers are exploring new ways to do surgery using slender instruments through the body's natural openings, avoiding cutting through the skin and muscle.

Many questions remain about that approach. But doctors say it holds the promise of providing a faster recovery with less pain and no visible scars. And in the brain, it can avoid a need for manipulating tissue that could disturb brain and eye function.

For abdominal surgeries, going through the mouth, vagina or rectum would avoid the need to cut through sensitive tissues. And deep inside the body, where tissue doesn't feel lasting pain, the procedures themselves might be less traumatic.

Some abdominal surgeries like bowel operations can require patients to spend a week or more recovering at home. With the natural-opening surgery, the theoretical hope is that "they really can go back to work the next day," said Dr. David Rattner of Massachusetts General Hospital.