The Surgeon

After his first weight-loss surgery three years ago, Paul Martin considered getting a tattoo designed around the four small surgical scars on his side—say, a golf green.

After a second weight-loss surgery in December, Martin didn’t have any new scars to add to the design. “I woke up with just a slight sore throat,” he says about the procedure, which took about two hours. “There wasn’t any pain because there weren’t any incisions.”

Martin, 53 years old, is among the first patients at Stanford Hospital & Clinics to be treated using what is called natural orifice surgery. In his case, the entire surgery was performed through his throat.

“We went down his throat with a device that looks like a regular endoscope, with a ‘duckbill’ on the end,” the surgeon, John Morton, MD, said. “In the duckbill is a tiny instrument like a sewing machine, with a needle that has plastic sutures.”

Morton, who is also associate professor of surgery, stitched pleats in the stoma, the opening between the patient’s intestine and the small pouch that had been created in the earlier surgery. He then tightened the pleats around the endoscope, reducing the stoma from 20 millimeters to 14, helping to control the amount of food Martin could digest.
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