Our Approach and Expertise

Minimal Access Surgery Program at NewYork-Presbyterian/Columbia University Medical Center

Marc Bessler, MD, Surgical Director, Minimal Access Surgery Program; Director, Columbia University Center for Metabolic and Weight Loss Surgery.Scarless surgery refers to a new, minimally invasive treatment option for procedures that previously required abdominal incisions. Scarless procedures involve less pain, shorter recovery times and improved cosmetic outcomes even compared to laparoscopic surgery. These surgical procedures are performed through the body's natural orifices without need for external incisions. Most scarless procedures are performed with the patient under general anesthesia.

Scarless procedures include endolumenal procedures, which are performed within an organ such as the stomach and leave no incisions at all, or natural orifice translumenal endoscopic surgery (NOTES), which is performed by making a small incision through the wall of an internal organ. Endolumenal procedures include fundoplication for GERD, reduction of the stomach pouch to treat obesity, and procedures done in the esophagus to treat achalasia. NOTES includes procedures to access the internal organs through a small internal incision, such as retro-uterine (behind the uterus) access of the gall bladder in women.

The Minimal Access Surgery Program also offers single port surgery, in which special articulating laparoscopic instruments are inserted through a single incision in the navel. The technique can be used for gallbladder removal and the weight loss procedure sleeve gastrectomy in patients who prefer the option over the natural orifice approach. It is also used for appendectomy. Single port surgery provides a better cosmetic outcome than traditional minimally invasive procedures. Recovery time is similar to other abdominal minimal access operations.

The multidiscisplinary team at the Minimal Access Surgery Program includes gastroenterologists, surgeons, interventional endoscopists, and gynecologists who work together to conduct this range of surgeries. Currently available procedures include:

  • Gallbladder removal—retro-uterine
  • Gallbladder removal—single port
  • Appendectomy—single port
  • Gastro-esophageal reflux disease (GERD) treatment—endoscopic
  • Revision of obesity surgery—endoscopic
  • Sleeve gastrectomy obesity surgery—single port and endogastric
  • Endogastric stomach plication for weight loss