Doctors Perform Surgery on Pancreas Through Man's Mouth

The softball-sized cyst on Eugene LaFlam's pancreas was killing him, and attacking it with traditional surgery wasn't an option.

He was so sick that there was little chance he'd heal from the cuts doctors would need to make into his abdomen and stomach to operate.

But thanks to a new technique that allowed surgeons to destroy the cyst by entering LaFlam's body through his mouth, the 72-year-old from Brattleboro, Vt., was ready to be released Friday from Baystate Medical Center and is expected to fully recover.

The operation is touted by hospital officials as the latest example of surgeries that avoid cutting into a patient by entering the body through its own orifices instead.

Similar procedures have been used to remove tumors and infected organs like gallbladders through a patient's mouth, nose, vagina or rectum.

Looking rested in a videotape that was played for reporters Thursday, LaFlam said, "I feel great now."

"It was a stupid gallstone that caused all my trouble," he said from his hospital bed in the recording made Wednesday. "But since they've done this procedure, boy do I feel good. Quite a difference."

In the months before his June 26 surgery at Baystate, LaFlam was on a ventilator because his breathing was so bad — a result of the complications caused by his inflamed pancreas.

"We were told that he wasn't going to make it," said his wife, Diane.

Knowing he was too frail to cut into, doctors first lowered an endoscope through LaFlam's esophagus and into his stomach and made an incision in the back wall of his stomach to create a passage to his pancreas.

During that procedure, surgeons were able to puncture the cyst in the hope that it would drain and disappear.

When the draining didn't work well enough, they returned to the cyst several weeks later by snaking a computer-controlled flexible tool into his esophagus and back through the opening in his stomach created by the endoscope. At the end of the device is an alligator clip-shaped stapler. The tool essentially popped the cyst like a balloon, and stapled its collapsed walls to LaFlam's stomach.

The solid material that was in the cyst will now be safely digested over time by the stomach.

"This is a tried and true surgical procedure done with a new technique," said Dr. John Romanelli, who helped with LaFlam's surgery.

"Six days after the surgery, we went back in to see how it was doing and it looked fantastic," he said.

The technique — which hospital officials say is covered by insurance — was a first for doctors at Baystate. But Romanelli and the other doctors who operated on LaFlam said they expect more of the so-called "natural orifice" surgeries to gain in popularity.

What would otherwise mean months of recovery from large incisions, or days of healing from laparoscopic surgery, can be almost completely eliminated, the doctors said.

"The whole driving factor is no scars, no pain," said Dr. David Desilets, who also operated on LaFlam. "That's why this is going to take off. Patients are going to demand it."

And some, like LaFlam, may have no other choice.