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Robot Snakes To Fight Cancer Via Natural Orifice Surgery

Hugh Pickens writes writes "BBC reports that on a robot snake that, guided by a skilled surgeon and designed to get to places doctors are unable to reach without opening a patient up, could help spot and remove tumors more effectively. Robot snakes could be as minimally invasive using body orifices or local incisions as points of entry. 'Surgery is a cornerstone treatment for cancer so new technologies making it even more precise and effective are crucial,' says Safia Danovi from Cancer Research UK. 'Thanks to research, innovations such as keyhole surgery and robotics are transforming the treatment landscape for cancer patients and this trend needs to continue.' Robot snakes could complement a robotic surgical system that has been used for the past decade — the Da Vinci surgical system — that is controlled by a surgeon sitting in a nearby chair and looking at a screen displaying the area of the body where the surgery is taking place. The surgeon manipulates the robot by pressing pedals and moving levers. Natural orifice surgery (warning: pictures of the inside of a person) has the potential to revolutionize surgery in the same way that laparoscopic surgery replaced open surgery. The objective is to enter the abdomen through an internal organ rather than through the skin — e.g. access via the mouth, esophagus and stomach, and then through the stomach wall. 'We are at the earliest stage of establishing the problems and proposing solutions,' says Rob Buckingham of OC Robotics, developer of the robot snake (video). 'Our prototype signals a direction of travel and is a milestone towards exploring a new surgical paradigm.'"

73 comments

  1. Mel Brooks Comes to Mind by Scarletdown · · Score: 4, Funny

    So having a living snake put up your ass is no longer merely a penalty for striking a Roman citizen now? Very creative.

    --
    This space unintentionally left blank.
    1. Re:Mel Brooks Comes to Mind by Anonymous Coward · · Score: 0

      a: Look here, you may have colon cancer, and I've got a snake. I'm trying to help you. Hold still dammit.
      b: That's not a snake and you know it! And you're just a dentist anyway.
      a: Shut up and stop being difficult. Use your imagination.
      b: It's got hair. WTF do you think you're doing, huh?
      a: The objective is to enter the abdomen through an internal organ rather than through the skin.
      b: You're fucking insane. Someone help me! Don't touch me! Get away!
      a: Ssssssnake! Sssssnaaaake!

    2. Re:Mel Brooks Comes to Mind by jsse · · Score: 3, Funny

      Relax, it's fine. Last time I have my doctor inserted that high-tech medical probe, which I have no idea what it was for, via my orifice and the whole process went very smoothly. He put his right hand on my right shoulder, and then put his left hand on my left shoulder, then inserted that snakey, slimy probe into my....

      HEY WAIT A MINUTE!

    3. Re:Mel Brooks Comes to Mind by outsider007 · · Score: 3, Funny

      You messed up the joke.
      Doctor: At first you're going to feel a little prick.
      Patient: Okay but how about buying a guy a drink first.
      Doctor: No problem, but I did I also mention the robot snakes crawling through all of your orifices?

      --
      If you mod me down the terrorists will have won
    4. Re:Mel Brooks Comes to Mind by craigminah · · Score: 3, Funny

      Or Samuel L. Jackson:

      "Enough is enough! I have had it with these motherfucking robot snakes in my motherfucking orifice!"

    5. Re:Mel Brooks Comes to Mind by Anonymous Coward · · Score: 0

      Senior citizen Jones and the Hospital of Doom:

      "Robot snakes! Why does it always have to be robot snakes?"

    6. Re:Mel Brooks Comes to Mind by DragonTHC · · Score: 1

      sounds more like it was created by a tentacle porn enthusiast.

      --
      They're using their grammar skills there.
    7. Re:Mel Brooks Comes to Mind by powerlinekid · · Score: 1

      "I'm tired of these motherfucking snakes in my motherfucking ass"?

      --

      can't sleep slashdot will eat me
    8. Re:Mel Brooks Comes to Mind by Anonymous Coward · · Score: 0

      "Oh, well THERE'S your problem..."

    9. Re:Mel Brooks Comes to Mind by Anonymous Coward · · Score: 0

      We welcome our new Oraficcial overlords. Snakes you say?

  2. TSA training by Tuqui · · Score: 4, Funny

    I just read that the TSA is training their agents in this techniques.

    1. Re:TSA training by mrkolin · · Score: -1

      I just read that the TSA is training their agents in this techniques.

      http://dogovietmy.vn/p158/tu-quan-ao.html

    2. Re:TSA training by niftydude · · Score: 4, Funny

      I just read that the TSA is training their agents in this techniques.

      I doubt it. Surely the last thing the TSA wants is a whole bunch of motherfuckin' snakes on a motherfuckin' plane.

      --
      You can never know everything, and part of what you do know will always be wrong. Perhaps even the most important part.
    3. Re:TSA training by ColdWetDog · · Score: 2

      I just read that the TSA is training their agents in this techniques.

      Sorry to break this to you, those are the TSA agents.

      --
      Faster! Faster! Faster would be better!
  3. I see one problem here. by Anonymous Coward · · Score: 0

    The problem is, you never know where it's been.

    1. Re:I see one problem here. by CodeheadUK · · Score: 1

      If it's got sweetcorn on it, send it back for another cleaning cycle,

  4. I guess... by Anonymous Coward · · Score: 0

    I've watched far too much anime.

  5. Highly inspiring by SpaghettiPattern · · Score: 4, Funny

    Quite inspiring title. I will, in fact, use it to augment my collection of suave pick up lines.

    --

    I hadn't the slightest objection to his spending his time planning massacres for the bourgeoisie... (P.G. Wodehouse)
  6. Old Tech by Anonymous Coward · · Score: 0

    I'm sure I've seen this in a Southpark episode where Cartman was getting a bit of "Natural orifice surgery".

  7. Stuxnet 2.0 ... by j35ter · · Score: 1

    ... targeting political opponents from within!

    --
    Delta-Mike November Bravo Tango
  8. But its already here by Anonymous Coward · · Score: 0

    My proctologist has been using his hose for acouple of decades and it nips small growths out of peoples. innards every day.

    1. Re:But its already here by ColdWetDog · · Score: 1

      My proctologist has been using his hose for acouple of decades and it nips small growths out of peoples. innards every day.

      That was a hose. This is a snake.

      Different.

      --
      Faster! Faster! Faster would be better!
  9. Kidney stones? by dutchwhizzman · · Score: 2

    I'd be very happy if they had those snakes at the local doctors office and they could be trained to crush my kidney stones. Man... this hurts.

    --
    I was promised a flying car. Where is my flying car?
    1. Re:Kidney stones? by Anonymous Coward · · Score: 0

      I'd be very happy if they had those snakes at the local doctors office and they could be trained to crush my kidney stones. Man... this hurts.

      tu mang: http://daiphutin.com.vn/tu-mang-tu-mang-dptr-c97

    2. Re:Kidney stones? by smooth+wombat · · Score: 1

      could be trained to crush my kidney stones.

      Drink more water. Not Mountain Dew or Jolt or whatever else. And not mixed with coffee, tea, cocoa or other additives. Straight water.

      You'll be amazed at the results.

      --
      We will bankrupt ourselves in the vain search for absolute security. -- Dwight D. Eisenhower
    3. Re:Kidney stones? by Fned · · Score: 1
  10. Am I the only one thinking ... by Anonymous Coward · · Score: 0

    Facehugger/Chestburster, Goa-Ould (alternative through-mouth-implant method), ...

  11. Fros&t pi5t by Anonymous Coward · · Score: -1

    of *BSD 44swipes

  12. And here I thought... by ravenlord_hun · · Score: 1

    ...that the creepy bug-machines they put in your stomach in Matrix1 were scifi only.

  13. So those anal probing aliens... by Anonymous Coward · · Score: 0

    Were they just trying to cure cancer?

  14. Robot snakes with lasers in your body by Chrisq · · Score: 2

    Robot snakes with lasers in your body. What could possibly go wrong! I know that one day we will look back at the times that unreliable human surgeons cut people, but I certainly wouldn't want to be an "early adopter" on this one.

  15. Too complicated by tftp · · Score: 1

    access via the mouth, esophagus and stomach, and then through the stomach wall.

    Option 1: the surgery is done via a camera, through the mouth, esophagus and stomach, and then through the stomach wall. Sutures will be also done by remote control - but they have to be secure enough to survive the acid of the stomach, and you better pray that they don't leak because that's bad news.

    Option 2: the surgery is done via a cut in the stomach wall; the surgeon has all the tools and all the visibility in the world. Your mouth and esophagus are not going to be scratched. Sutures on the stomach wall are trivial, it's easy to see them, and if they fail they won't kill you, and they can be easily repaired.

    Which one I would choose, I wonder? Is there a surgeon on /. that would volunteer a professional opinion?

    1. Re:Too complicated by Herve5 · · Score: 5, Interesting

      I once got my stomach observed -the classical observation, no surgery.
      The process is a bit shocking (mainly because once you have this big tube inserted in your esophagus you cannot talk anymore, and it's more impressive that you may think)
      I can say they start with an empty stomach, and inflate it (with just air, through the tube) so yes the visibility is near perfect.
      Then within my observation they took samples: basically, they have a sharp tool that will just scorch a bit out, and basically they leave the wound unattended, and it heals, and you even don't feel anything neither at scorch time nor after. (you do feel the scorch traction mind you, a bit like when a dentist throws a tooth away from your mouth: 'hummph' -hey what what is he doing? but then it's just over ;-)
      So, while definitely not a professional myself, I'd say reaching the stomach wall and getting through it *is* easy and not consequential, apart psychologically...

      --
      Herve S.
    2. Re:Too complicated by Anonymous Coward · · Score: 0

      That's not actually anywhere near as hard as you're making it sound. I'm not a surgeon, but I did have an endoscopy where they went in the mouth all the way down to the duodenum and took a biopsy.

      What you're forgetting is that surgery is always done after the patient has been fasting. So, even if PH were a problem, the patient could presumably take a proton pump inhibitor or similar to knock it down. But, without food in the stomach, I don't think that there's much stomach acid being secreted as that would damage the lining of the stomach more quickly.

      However, that's not really necessary, when they do endoscopies they don't need to worry about it, so I'm guessing it's not a big deal.

      The endoscopy route is preferable as you don't have to cut so many huge holes in the body, and the stomach is a particularly nasty one if the subsequent effort of closing it up doesn't go well. Having a perforated ulcer is quite serious. But without all that cutting, I'd imagine it would be day surgery.

    3. Re:Too complicated by Darinbob · · Score: 1

      Well similar to colonoscopy. Inflate the colon to get a better look around. They don't really tell you how all that air comes out later though I recall a nurse saying "dissipate" over a couple hours. What really happens though is that it most came back out in about twenty seconds when I got home. But because of the lube it was silent otherwise I could have played Yankee Doodle.

  16. All I want to know is by SmallFurryCreature · · Score: 2

    Does the Japanese porn industry have one of these snakes?

    The potential is limitless!

    --

    MMO Quests are like orgasms:

    You may solo them, I prefer them in a group.

  17. Stargate plot? by Anonymous Coward · · Score: 0

    Hmm. That sounds like the plot to Stargate.

    I wonder if it'll give the recipients the ability to make their eyes glow mysteriously?

  18. Re:I guess...yeah me too by Anonymous Coward · · Score: 0

    I watched a lot of anime, even more of the Simpsons and I for one welcome our new anus invading robot snake overlords!

  19. Haven't I seen this before? by DSS11Q13 · · Score: 1

    I'm pretty sure this premise undergirds the entirety of the Japanese pornography industry.

  20. That's it! I've had it! by Anonymous Coward · · Score: 0

    I'm sick of these motherfuckin' snakes on this motherfuckin' pla--wait a minute...

  21. Tails LiveCD: one of many reasons to dump it 4good by Anonymous Coward · · Score: -1

    A simple Q&A in this thread turned into trash:

    https://tails.boum.org/forum/0.13_-_new_problem_-_dropped_packets_being_logged/

    The frustrated user posted:

    --
    I use Tails to use Tor. I expect Tor to work as designed. Tails giving a hello, encrypted or not, back to the mothership, reminds me of most Windows machines which hit Microsoft's time server(s) with each boot.

    Instead of leading me in different directions, talking me through a maze of other options, please tell me how to disable this communication between my boot-up of Tails and the Tails server(s): the initial count or ping/hello and the security checks.

    I know how to check your site for updates. I don't need the program checking and I don't want any boot stats provided to you from my system, encrypted or not.

    Please tell me how to disable all of that - without the info on building my own Tails distro. It cannot be that difficult. This is an open OS, right? Let's appear more open in our replies and to the point.

    --

    No clear answer was given, but some user(s) rushed in to aid:

    "And this is precisely what have been implemented"

    Seriously now. PELD just documents your implementation, written in RFC style to appear more profound. I bet intrigeri wrote that part after implementing the feature in Incognito first.

    And FFS, listen to your users. You can start with one of those useless TODO pages, outlining different approaches to checking for updates, and the way for users to control those.
    ---

    ---
    "Sorry, but it is the opposite. We usually first design and then implement, as most good software development practice advice to do. The PELD has been written a long time ago. It is periodically updated when we find and design new features / issues. Usually through the cycle of writing todo pages where ideas are discussed."

    LOL. Are you the bullshitter in charge or something? Have you considered the career of presidential press-secretary or similar? I find it amazing how all you seem to care about is damage control using weasel words and hand-waving, and are completely disinterested in the actual truth.

    Let me help you here. Commit adding the real-world experience passage: Dec 14, 2010. Security checker implementation: Feb 4, 2010.

    In other words: Incognito's documentation has been adapted to the situation in Amnesia after-the-fact. Nothing was discussed. No TODO pages were created. Amnesia was "pinging the mothership", in words of the user above, long before PELD was imported and updated. That passage did not exist. Will you admit now that you were plain out bullshitting, or do I need to play out the whole dead parrot scene by Monty Python?

    "We already do that, sorry if you are not our only user."

    I am not even the same guy. You seem to have a problem with the idea that more than one person might disagree with your "one true vision".

    "For other people, please don't come into his game by replying to his provocations."

    Whereas all you are doing is replying to non-provocations with bullshit. Well done!
    --

    Finally, the OP responded:

    "I find it amazing how all you seem to care about is damage control using weasel words and hand-waving, and are completely disinterested in the actual truth"

    Agreed, I've never encountered such defensive, empty, and negative, or out right hostile responses as I have here, especially to simple questions!

    This is the last version of Tails I use. It's easier to pick from any number of Linux distros and use a LiveCD with TBB and not run into stupid shit and the same for answers.

    Have fun 'counting' others, or whatever bullshit voodoo you have going on in scripts and/or binaries you fail to deliver simple answers for, there will no longer be any Whispers, backs, or TAILS for me anymore.

    Heads, I win..

    Tails you lose!
    --

    When you begin picking apart t

  22. No thanks! by RivenAleem · · Score: 1

    The surgeon manipulates the robot by pressing pedals and moving levers...

    ... while cackling maniacally and screaming "It's Alive!!!"

  23. endoscope by kenorland · · Score: 3, Interesting

    There are plenty of endoscopic surgeries already. People are attaching more actuators to the front to help with steering, but for obvious reasons, you want to keep these things as small as possible. Why you would want to shove the "robot" from the article up your behind is instead of a standard endoscope is beyond me.

  24. Pick-up lines! by alendit · · Score: 2

    I've got a biological snake that can cure cancer via natural orifices... ...if you know what I mean.

    1. Re:Pick-up lines! by Haawkeye · · Score: 1

      Nice!

  25. What kind of idiot ... by dltaylor · · Score: 2

    Compared to skin (heals rapidly, and can be kept clean while healing with modern methods), puncturing the alimentary canal (mouth to anus) is REALLY stupid. Bathed in dangerous chemicals, hostile bacteria (when not confined to their natural environment), and requiring tricky nutrition for the patient while healing), that is no place to be poking holes into the interior of the body (remember, topologically, it's the same as the outside).

    Using the "snakes" to treat polyps, ulcers, cancers, or other issues within the alimentary canal does have some potential advantages over the combination of both puncturing the skin and the alimentary canal to reach them.

    1. Re:What kind of idiot ... by Anonymous Coward · · Score: 0

      If you checked out the wikipedia link, the internal picture is after penetration via vagina.... so this technique is more like your average dumb connotation than you might expect.

    2. Re:What kind of idiot ... by bughunter · · Score: 1

      Yes, our layman's snap judgement - based on ignorance, popular culture, generalizations, and simplifications - is far more reliable and insightful than peer reviewed research performed by specialists in medicine and backed up by analysis and experimentation.

      That viewpoint certainly justifies the accusation of someone being an 'idiot,' indeed.

      --
      I can see the fnords!
  26. New Zealand has already done it. by Anonymous Coward · · Score: 0

    When I saw this article headline "Robot Snakes To Fight Cancer Via Natural Orifice Surgery" I thought, bah, dupe. New Zealand is the world leader in Natural Orifice Surgery, but they use eels.

    From their news yesterday:
    "Hospital removes eel from man's bum"
    http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10835890

    1. Re:New Zealand has already done it. by Anonymous Coward · · Score: 1

      What do you call a man with 20 rabbits up his bum?

      Warren.

    2. Re:New Zealand has already done it. by Anonymous Coward · · Score: 0

      Oh, I thought he was just hoppy to see me...

      - T

  27. Headline of the day by Anonymous Coward · · Score: 0

    I'd say be careful what context you use that in, but I fail to think of a context where that would be suitable.

  28. robot snakes by Anonymous Coward · · Score: 0

    my ass

  29. Previous attempts not so successful by hairyfarter · · Score: 0

    Previous attempts by Chinese researchers haven't been as successful: http://articles.latimes.com/2011/sep/16/news/la-heb-eel-penis-spa-urethra-20110916

  30. complications can necessitate conversion to "Open" by girlinatrainingbra · · Score: 1

    Complications may necessitate conversion to "Open surgical" approaches, the traditional trans-abdominal wall lapartomy. Option 1b: surgery gets complicated, something gets ruptured (hope its not an artery) and the operation has to be converted to open laparotomy. Option 2b: laparscopic approach via small incisions in the abdominal wall gets complicated, something gets ruptured, and the operation has to be converted to open laparotomy. In either case, open laparotomy with a longer abdominal scar will be necessary. There's a lot of experience with laparoscopic approaches and with converting to open in case of emergency. There isn't much (or any) experience with trans-stomach wall for most surgeons. There have been problems with kidney and liver veins and arteries being nicked during lap. cholecystectomies (gall-bladder surgery) and even cases of kidneys being lost during trans-vaginal approaches to the abdominal cavity. The mucosal walls heal well and are less likely to be exposed to external infection, so that's one benefit; but the likelihood of other complications cannot be quantified yet. (as for mucosal walls, there are also transoral approaches to spinal surgery for the odontoid, and the pull the lips up to transect through the nose for brain surgery of the pituitary, and the oral musoca heals very well.)

  31. Very Nice by Anonymous Coward · · Score: 0

    :)

    http://www.APHerald.com

  32. UC patient here by Anonymous Coward · · Score: 1

    as a suffer of ulcerative colitis for years including extended hospital stays (but now 1.5 months symptom free, thank you Remicade :) ), it gets psychologically even more intense. i also had an endoscopy performed and i agree, the science of getting a tube into the stomach is basically solved (but you didnt mention if you recieved a sedative or not? i hope so!). but the colon is completely different and this is an area of research that can still be improved upon tremendously. getting something stuck into there, that to the brain seems limitless in length, is something tough to deal with psychologically. if its a dildo or whatever other object, yeah you see that it has an "end" and you can deal with it. but that tube is damn long.

    i remember once i was seeing a doctor, who had a special practice with all the equipment setup to give colonoscopies, except that he didnt have the necessary sedatives, so i got one without the sedative. i think he went like 15-20 inches or so, only to the "first turn", but it was completely fucking horrible because my brain could not comprehend what was happening. he kept pumping in the gas, and you know, if his finger slips or something it could mean something serious. im not emotionally or psychologically scared or anything like that, ive had many colonscopies but they usually came with the sedative.

    whatever, people can cue with the gay sex jokes ). but bowel disease, especially immflamatory bowel disease, is becoming a big issue in the west, but not something that people generally talk about so openly, obviously due to its taboo nature.

    1. Re:UC patient here by jasper160 · · Score: 1

      My little brother with Crohns went through that hell too as a small child, back when pain mangement was scoffed at. The less invasive and painful it can be the better.

      --
      No good deed goes unpunished.
    2. Re:UC patient here by Anonymous Coward · · Score: 0

      Not the GP, but an endoscopy only requires a sedative if you lack discipline and you're better off going without if at all possible. The doctor tried to hard sell me on it, but I stood my ground. It was a bit awkward having something that thick in my throat, but you're not going to choke on the thing and even if you do, they can pull it out in seconds.
      They give you something to numb your tongue and really, it isn't anywhere near as unpleasant as people would imagine. Now, if I was going to have surgery like that, I'd almost certainly opt for general as I'm not sure they've really figured out how to use a local to operate inside the stomach.
      As a general rules, never get a general anaesthetic if you can at all help it. Keeping a person barely alive for a procedure is a tough process and even with the best doctors there's always the possibility that you won't wake up.

    3. Re:UC patient here by Anonymous Coward · · Score: 0

      sometimes people explode during colonoscopies. WTF Google!

      http://io9.com/5945897/sometimes-people-explode-during-colonoscopies-heres-how-that-happens

      captcha: touchily

  33. Really? by darkfeline · · Score: 1

    Robot snakes? Natural orifice surgery? And yet not a single post connecting that to—ahem—any tentacular references? You surprise me, Slashdot.

  34. Natural by rossdee · · Score: 1

    What exactly is natural about robot snakes up your ass ?

  35. Cancer Survivor by Haawkeye · · Score: 3, Insightful

    As a cancer survivor the surgery to remove the tumour sucked. Actually the whole experience was not great. However if they have a way of removing it without cutting me up I am all for it. One less thing to recover from! The only good thing was thank god I live in Canada. I had time off work with pay and the entire treatment was free. So while having cancer was bad at least it didn't bankrupt my family.

  36. Snakes?! by Anonymous Coward · · Score: 0

    All I wanted was sharks with freaking laser beams on their freaking heads!

  37. Was this inspired by by rtobyr · · Score: 1

    Was this inspired by robot scorpions in your belly-button?

  38. Morphine by SmallFurryCreature · · Score: 1

    Get it, it is the only thing that works.

    You will be in lala-land but at least the pain will be gone.

    --

    MMO Quests are like orgasms:

    You may solo them, I prefer them in a group.

  39. What's that .... by PPH · · Score: 1

    ... Roto Rooter truck doing parked outside the ER?

    --
    Have gnu, will travel.
  40. Robots.txt by Anonymous Coward · · Score: 0

    I knew there was a reason I had robots.txt tatood on my ass !

  41. Heres to... by englishknnigits · · Score: 1

    hoping the butt snakes don't become self aware and escape into the wild.

  42. Pictures of the inside of a person by bill_mcgonigle · · Score: 1

    (warning: pictures of the inside of a person)

    Meanwhile seven children were killed by drone strikes last week and nobody was reported feeling queasy.

    So, this is how societies fail...

    --
    My God, it's Full of Source!
    OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
  43. We can dominate world with this! by kubusja · · Score: 1

    The snake can grow inside a person and when grown - go out through person's abdomen and go and fight for the world domination! For better effectivnes double-jaws are suggested as well...

  44. Yeah... by Anonymous Coward · · Score: 0

    I've seen enough hentai to know where this is going...

  45. aka NOTES surgery, one less wound to recover from. by girlinatrainingbra · · Score: 1
    Natural orifice translumenal endoscopic surgery (NOTES surgery is the full name for this type of surgery going through natural orifices. There are a few conferences on it yearly in the US and UK and Europe alone that I know of, and the Japanese also have some conferences on it. The lack of an externally observable scar is one benefit, and the ability of wet mucosal membranes to heal more readily is another benefit. The risk of complications and need to convert to open surgical approaches is unquantified thus far, as the procedures are fairly new. (Kind of like how brand new drugs have very few known side effects. Once they get out into a larger population using it that the Phase I and II trials, the known side effects grow rapidly. ) Same thing with new surgical procedures: you can honestly say there are few known side-effects or bad outcomes, but that's just a result of there being so few procedures performed so far. That's hype.

    Complications may necessitate conversion to "Open surgical" approaches, the traditional trans-abdominal wall lapartomy.

    Option 1b: surgery gets complicated, something gets ruptured (hope its not an artery) and the operation has to be converted to open laparotomy.

    Option 2b: laparscopic approach via small incisions in the abdominal wall gets complicated, something gets ruptured, and the operation has to be converted to open laparotomy.

    In either case, open laparotomy with a longer abdominal scar will be necessary. There's a lot of experience with laparoscopic approaches and with converting to open in case of emergency. There isn't much (or any) experience with trans-stomach wall for most surgeons.

    There have been problems with kidney and liver veins and arteries being nicked during lap. cholecystectomies (gall-bladder surgery) and even cases of kidneys being lost during trans-vaginal approaches to the abdominal cavity. The mucosal walls heal well and are less likely to be exposed to external infection, so that's one benefit; but the likelihood of other complications cannot be quantified yet. (as for mucosal walls, there are also transoral approaches to spinal surgery for the odontoid, and the pull the lips up to transect through the nose for brain surgery of the pituitary, and the oral musoca heals very well.)