By Dr Santi Pongphantarak, MD
Tubal sterilisation through Natural Orifice Transluminal Endoscopic Surgery (NOTES) has been used abroad for more than 10 years, but is still a relatively new technique in Thailand.
TUBAL sterilisation through Natural Orifice Transluminal Endoscopic Surgery (NOTES) has been used abroad for more than 10 years, but is still a relatively new technique in Thailand.
The method involves inserting a tiny camera and surgical instrument through the vagina, which is the body’s natural opening, so as to view the area that cannot normally be seen. This means there is no need to make any abdominal incisions. This technique is not only used for sterilisation of women, but can also be applied to other treatments, such as removing the fallopian tubes due to an ectopic pregnancy, removing an ovarian cyst, as well as performing a hysterectomy, with no postoperative scarring.
However, there are very few surgeons who can perform the NOTES technique for sterilisation. Even though this technique is a preferred method for sterilisation, it is not often the first option chosen by most practitioners.
Suitability for each individual patient depends on the results of a medical assessment and of course whether the patient wishes to use this method.
There are other advantages and benefits of tubal sterilization through NOTES. When people think of sterilisation, they usually believe that surgery is required. They become uneasy at the thought of the pain and hazards involved. Traditional endoscopic surgery causes minimal pain, but due to the greater number of pain receptors in the abdominal region, it is still more painful than making an incision in the vaginal lining, which is painless and will leave no visible scar. This method is highly preferable for most women, in part, for aesthetic reasons. Moreover, there is less chance of infection using this method. Additionally, traditional endoscopic surgery has some limitations for patients who have had previous surgeries and are left with excessive abdominal scarring. This technique is the answer for some, but not all; for many it is a better option than traditional surgery.
Before the decision is made to undergo tubal sterilisation through NOTES, the husband and wife must be |positive that they are ready to terminate their ability |to have additional children, because this technique is |permanent. Although attempts could be made to reverse this procedure, it would be very difficult, so patients |need to be certain of the decision to undergo tubal |sterilisation.
Having tubal sterilisation through NOTES requires only standard preparation and the associated expenses are not as high as one would expect. If you can afford to undergo endoscopic surgery for sterilisation, then the cost of tubal sterilisation through NOTES will not be an issue.
If you think it is time for contraception by sterilisation that leaves no scarring, is painless and affordable, this method should be your first choice.
Dr Santi Pongphantarak is an expert in Gynaecologic Laparoscopic surgery attached to the Women’s Health Centre of Samitivej Sukhumvit Hospital. Call (02) 022 2222.