Natural orifice translumenal endoscopic surgery (NOTES)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Mohammed A. Sbeih, M.D. [2]

Related Key Words and Synonyms: Natural orifice translumenal endoscopic surgery, single incision laparoscopic surgery, minimally invasive surgery, transanal endoscopic microsurgery.

Overview

Natural orifice translumenal endoscopic surgery (NOTES) is an experimental surgical technique whereby "scarless" abdominal operations can be performed. The surgeon accesses the peritoneal cavity or the thoracic cavity via a hollow viscus and performs diagnostic or therapeutic procedures. NOTES involves passing surgical instruments and a tiny camera through a natural orifice (mouth, urethra, anus, etc.), then the procedure can be performed through an internal incision in the stomach, vagina, bladder or colon, thus avoiding scars and external incisions through the skin, muscles, and nerves. The patients recover more quickly and experience less pain with better cosmetic results. The postoperative complications such as wound infections and hernias are significantly reduced.

Animal models and cadavers have been used to demonstrate the possible applications of NOTES, including abdominal cavity screening, abdominal organs biopsy, appendectomy, Cholecystectomy, tubal ligation, gastrojejunostomy, partial hysterectomy, oophorectomy, colorectal resection and trans-esophageal myotomy.

Historical Perspective

NOTES Advantages Over Current Surgical Techniques and The Single Incision Laparoscopic Surgery (SILS)

Experimental Evolution

What has been achieved so far?

  • Laboratory Reports
  • Human Cases

Current Challenges to Clinical Application of NOTES and the Drawbacks

Human Experience

Potential Applications

  • Transvaginal NOTES
  • Transrectal NOTES
  • Transgastric NOTES
  • Transesophagea NOTES
  • Transurethral/Transcystic NOTES

Future Directions

Current Technologic Developments

Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR)

Conclusions

Published Studies

Videos

External links

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References

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