Asian-Chinese patient perceptions of natural orifice transluminal endoscopic surgery cholecystectomy

Patient and physician perceptions of natural orifice transluminal endoscopic surgery (NOTES) have been reported for the Western population. However, whether Asian-Chinese patients share the same perspectives as compared to the Western population is unknown.

This was a cross-sectional survey carried out in the surgical outpatient's clinic at the Prince of Wales Hospital between June and September 2011. Patients were provided with an information leaflet and asked to complete a questionnaire regarding their perceptions of and preferences for NOTES cholecystectomy. Female patients attending the clinic were given an additional questionnaire regarding attitudes towards transvaginal surgery.

Two hundred patients were recruited to complete the questionnaire(s) and the male to female ratio was 1:1. One hundred and fourteen patients (57%) preferred to undergo NOTES cholecystectomy for cosmetic reasons (P=0.009). Oral and anal routes were both acceptable for NOTES accesses in males and females. Forty-one percent of the female patients would consider transvaginal NOTES. Of these patients, significantly more patients indicated that the reason for choosing transvaginal NOTES was to minimize the risk of hernia (P=0.016) and to reduce pain associated with the procedure (P=0.017). The risk of complications (84.5%) and the cost of the procedure (58%) were considered the most important aspects when choosing a surgical approach by Asian-Chinese patients.

Asian-Chinese preferred NOTES mainly for cosmetic reasons. However, the transvaginal route was less acceptable to females. Significant differences in patient perception on NOTES were observed between Asian-Chinese and Western patients.