title: Women's positive perception of transvaginal NOTES surgery.
abstract: BACKGROUND
  Two decades ago, minimally invasive surgery (MIS) was introduced and led to a revolution in modern surgery. Currently MIS procedures are the standard of care for many surgical interventions and patients often seek out surgeons with special training in MIS. Today, natural orifice transluminal endoscopic surgery (NOTES) appears to be on the threshold of another such revolution. We surmise that its advantages are similar to those of other MIS procedures, but there are no associated abdominal wall complications as there are no abdominal incisions. To date, there is no data evaluating women's perceptions of such a procedure and their willingness to consent to this type of surgical approach.
  
  
  METHODS
  We surveyed 100 women who were given a written description of MIS and NOTES surgery along with a 10-question survey exploring their concerns and opinions regarding transvaginal surgery.
  
  
  RESULTS
  The majority of women (68%) indicated that they would want a transvaginal procedure in the future because of decreased risk of hernia and decreased operative pain (90 and 93%, respectively), while only 39% were concerned with the improved cosmesis of NOTES surgery. Of the women polled, nulliparous women and those under age 45 years were significantly more often concerned with how transvaginal surgery may affect healthy sexual life and fertility issues (p < 0.05). Of the women who would not prefer transvaginal surgery, a significant number indicated concerns over infectious issues (p < 0.05).
  
  
  CONCLUSIONS
  Our study shows that there is considerable public interest in NOTES surgery and women would be receptive to this new surgical technique. Our study highlights a strong need for early reporting of outcomes data to enlighten ourselves, and our patients, about this exciting new technology.
authors.affiliation: Department of Minimally Invasive Surgery and Robotic Surgery, Center for the Future of Surgery, University of California, San Diego, CA, USA.
authors.forename: Carrie Y
authors.initials: CY
authors.lastname: Peterson
authors.forename: Sonia
authors.initials: S
authors.lastname: Ramamoorthy
authors.forename: Barbara
authors.initials: B
authors.lastname: Andrews
authors.forename: Santiago
authors.initials: S
authors.lastname: Horgan
authors.forename: Mark
authors.initials: M
authors.lastname: Talamini
authors.forename: Alana
authors.initials: A
authors.lastname: Chock
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003625:Data Collection; D004414:Dyspareunia / Q000517:prevention & control; D004724:Endoscopy / Q000379:methods / Q000523:psychology*; D004954:Esthetics; D005260:Female; D046449:Hernia, Abdominal / Q000517:prevention & control; D006801:Humans; D007239:Infections; D007247:Infertility, Female / Q000517:prevention & control; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010342:Patient Acceptance of Health Care; D010361:Patients / Q000523:psychology*; D011183:Postoperative Complications / Q000517:prevention & control; D014621:Vagina; D014930:Women / Q000523:psychology*; D055815:Young Adult