Scarless Surgery/NOTES

Transvaginal SurgeryClick here to view Invisible Incision Appendectomy video

The procedure, called Natural Orifice Translumenal Endoscopic Surgery (NOTES), involves passing surgical instruments and a tiny camera through a natural orifice, such as the stomach or the vagina, to perform surgery. By avoiding major incisions through the skin, muscle, and nerves of the abdomen, patients recover more quickly, experience less pain and have no visible scars on their abdomen while the risk of post-operative complications such as wound infections and hernias is significantly reduced.


Kurt Roberts, MD

Kurt Roberts, MD, is a board-certified general surgeon who is fellowship-trained in minimally invasive surgery. He is one of the pioneers who developed scarless surgery in the United States and around the world. He successfully performed what is believed to be the first transvaginal appendectomy with no abdominal incision whatsoever in the United States where the patient's appendix was removed through a small incision in the vagina. Without incisions in the abdomen, there is no opportunity to develop surgery-related hernias or wound infections. Patients who undergo procedures such as these recover and resume most normal activities within just a few days. In fact, the first woman who underwent this procedure only took one Tylenol for pain control and resumed her normal activities within two days after surgery. Since the incision in the patient’s vagina is very small and the female reproductive organs, especially the uterus, are bypassed with this type of surgery, child bearing and sex life are not affected.

Since his first transvaginal appendectomy in August 2008, Dr. Roberts has performed several transvaginal appendectomies and has extended this new technique to the removal of gallbladders. The first transvaginal gallbladder surgery took less than an hour-and-a-half and the female patient went home three hours later. She was able to recover quickly, with minimal post-operative pain and no visible scars. Most importantly, she was able to return to full activities very quickly with a far lower risk for a wound infection than might have resulted from traditional laparoscopic gallbladder removal, which usually requires four incisions through the abdominal muscles.

Single Port Surgery or SILS (Single Incision Laparoscopic Surgery)

Kurt Roberts, MD, is also considered one of the pioneers who advanced minimally invasive surgery and developed surgical techniques including Single Port Surgery or Single Incision Laparoscopic Surgery (SILS), i.e. removal of the appendix or gallbladder through only one small incision hidden in the umbilicus (belly button).

Starting as early as 2007, Dr. Roberts has performed numerous single incision surgeries such as single port removals of the gallbladder or appendix. A single port laparoscopic surgery performed with only one small incision is less invasive than the usually laparoscopic surgery, which uses three or four incisions. One incision equates to less pain, shorter recovery time and better cosmesis for the patient and the ability to return to routine activities or work more quickly.

Scarless Surgery or Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Single Port Surgery are becoming increasingly popular because they are even less invasive than traditional laparoscopic surgery, which still requires multiple abdominal incisions. If you are interested in Scarless Surgery, No-Incison Surgery (NOTES), Single Incision Surgery or have any questions concerning the described procedures, please contact Dr. Roberts at kurt.roberts@yale.edu or make an office appointment at (203) 764-9060.