Single-Incision and Natural Orifice Translumenal Endoscopic Surgery in Switzerland.
Single-incision laparoscopy (SIL) and natural orifice translumenal endoscopic surgery (NOTES) aim at reducing surgical access trauma. To monitor the introduction of emerging technologies, the Swiss Association for Laparo- and Thoracoscopic Surgeons launched a database in 2010. The current status of SIL and NOTES in Switzerland is reported, and the techniques are compared.



The number and type of procedures, surgeon experience, their impressions of performance, conversion, and complications between 2010 and 2015 are described. A survey was used to acquire additional data not included in the registry.



Nine centers included 650 procedures. Cholecystectomy (55 %) and sigmoidectomy (26 %) were most prevalent in both techniques. The number of active centers declined from 9 to 2 during the study period. The frequencies of taught procedures were 4 and 43 % for SIL and NOTES (p < 0.001), and surgeon self-estimated impression of performance was perfect in 50 and 89 %, respectively (p < 0.0001). Conversions in total were 3.6 and 5.7 %, respectively, and 1.1 % to open for both techniques. Morbidity was 5 % in SIL and 2.7 % in NOTES, with 0.8 % access-related complications in NOTES and none in SIL (p = 0.29). Of laparoscopic cholecystectomy, sigmoidectomy, and right hemicolectomy, 11.4 and 15.6 % of cases were operated using SIL or NOTES, respectively (p < 0.0001).



Although in selected specialized centers, a considerable proportion of patients were treated using novel techniques, a fading interest of the surgical community in SIL and NOTES was observed. The proportion of SIL and NOTES procedures taught is insufficient and calls for improvement.
Department of Surgery, Cantonal Hospital Baselland, Site Bruderholz, 4101, Bruderholz, Switzerland. daniel.steinemann@gmx.ch.
Daniel C
DC
Steinemann
Department of Surgery, Cantonal Hospital Baselland, Site Bruderholz, 4101, Bruderholz, Switzerland.
Andreas
A
Zerz
Department of Surgery, Cantonal Hospital Winterthur, Brauereistrasse 15, 8401, Winterthur, Switzerland.
Michel
M
Adamina
Department of Surgery, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland.
Walter
W
Brunner
Department of Surgery, Cantonal Hospital Baden, Im Ergel 1, 5404, Baden, Switzerland.
Andreas
A
Keerl
Department of Surgery, Cantonal Hospital Baden, Im Ergel 1, 5404, Baden, Switzerland.
Antonio
A
Nocito
Department of Surgery, Cantonal Hospital Lucerne, Spitalstrasse, 6000, Lucerne, Switzerland.
Andreas
A
Scheiwiller
Department of Surgery, Hospital Zollikerberg, 8125, Zollikerberg, Switzerland.
Rene
R
Spalinger
Department of Surgery, Hospital Emmental AG, 3400, Burgdorf, Switzerland.
Stephan A
SA
Vorburger
Department of Surgery, Cantonal Hospital Baselland, Site Bruderholz, 4101, Bruderholz, Switzerland.
Sebastian H
SH
Lamm
D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D012042:Registries; D013514:Surgical Procedures, Operative / Q000379:methods / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology
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