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Updated: Jul 15, 2026
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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
[The natural orifice surgery concept. Vision and rationale for a paradigm shift]
T Benhidjeb1, K Witzel, E Bärlehner
1The New European Surgical Academy (NESA), Berlin-Buch. tbenhidjeb@nesacademy.org
Summary
Natural orifice surgery (NOS) offers a simpler, safer approach to abdominal procedures. The trans-Douglas endoscopic device (TED) facilitates single-entry surgery, demonstrating feasibility and potential for improved patient outcomes.
Area of Science:
- Minimally Invasive Surgery
- Surgical Innovation
- Gastroenterology
Background:
- Laparoscopic surgery significantly reduced morbidity in the 20th century.
- Natural orifice surgery (NOS) is a novel approach for simpler, safer procedures.
- NOS accesses the abdominal cavity via transoral, transvaginal, or transanal routes.
Purpose of the Study:
- To describe the rationale behind natural orifice surgery.
- To outline the anticipated challenges of NOS.
- To introduce the trans-Douglas endoscopic device (TED) for NOS procedures.
Main Methods:
- Established the first European working group focused on NOS.
- Concentrated on developing trans-Douglas procedures for women.
- Utilized the trans-Douglas endoscopic device (TED), a multi-channel instrument for single-entry surgery.
Main Results:
- Simulated various intra-abdominal operations including staging, cholecystectomy, appendectomy, myomectomy, and oophorectomy using the TED.
- Practical studies are scheduled for the near future.
Conclusions:
- Experimental studies have confirmed the feasibility of NOS.
- NOS is expected to enable innovative, high-quality operations.
- The NOS technique holds the potential to enhance patient safety.
