While the concept of natural orifice surgery has been around for 20 years, only 1% of colorectal procedures use a natural orifice in current clinical practice. The benefits are clear: smaller incisions, fewer complications, less pain, less infection and shorter recovery. But until now, techniques have proven to be difficult. Dr. Eric Haas and his team have developed a feasible, effective, safe process for robotic colorectal resection using a natural orifice for intracorporeal anastomosis and tumor or specimen extraction.

The NICE procedure (natural orifice intracorporeal anastomosis with extraction of specimen) is reproducible with consistent results:

• The national average for length of stay is five to eight days. With the NICE procedure, average length of stay is now reduced to 2.3 days.
• Complication rates are significantly reduced, and we have complete elimination of surgical site infections involving the skin incisions.
• Readmission rates are cut in half from 14% to 6%.
• Patients return to work in two to three weeks versus six to 12 weeks. NICE is a procedure that can help patients suffering from diverticulitis, colorectal cancer, endometriosis and other forms of colorectal disease.

Dr. Haas’ early experience with NICE was published in the American Journal of Surgery (April 2019, Volume 217, Issue 4). He and his team have since been asked to present results and the NICE procedure itself at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) conference and the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR). They have traveled across the country training colorectal surgeons on NICE.