title: NOTES. Study on patients' perspective.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To evaluate patients' opinions on the four surgical approaches: open, laparoscopic, transvaginal and transgastric.
  
  
  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.
authors.affiliation: Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland.
authors.forename: Jarek
authors.initials: J
authors.lastname: Kobiela
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stefaniak
authors.forename: Dariusz
authors.initials: D
authors.lastname: Laski
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Mackowiak
authors.forename: Alicja
authors.initials: A
authors.lastname: Czurylo
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Hac
authors.forename: Andrzej J
authors.initials: AJ
authors.lastname: Lachinski
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Sledzinski
keywords: NOTES; minimally invasive surgery; transvaginal cholecystectomy