The eagle or the snake: platforms for NOTES and radical endoscopic therapy

Area of Science:

• Minimally invasive surgery
• Gastroenterology
• Surgical innovation

Background:

• Natural orifice translumenal endoscopic surgery (NOTES) has emerged as a significant development in minimally invasive procedures.
• While gaining recent attention, the underlying concepts of NOTES have been evolving for approximately ten years.
• The advancement of NOTES necessitates a review of fundamental principles in therapeutic flexible endoscopy.

Purpose of the Study:

• To revisit basic concepts of therapeutic flexible endoscopy.
• To establish fundamental premises for developing a robust technology program for NOTES.
• To provide a foundational review emphasizing general principles over specific technical implementations.

Main Methods:

• Review of existing literature and foundational concepts in flexible endoscopy.
• Analysis of the theoretical underpinnings of NOTES.
• Emphasis on general principles for technology development.

Main Results:

• Identification of core principles in therapeutic flexible endoscopy relevant to NOTES.
• Outline of foundational premises for a structured NOTES technology development program.
• Highlighting the nascent stage of specific NOTES embodiments.

Conclusions:

• A strong foundation in flexible endoscopy principles is crucial for successful NOTES development.
• General principles should guide the nascent technology development for NOTES.
• Further exploration of fundamental concepts will support the advancement of NOTES.