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Endoscopic Suturing, an Essential Enabling Technology for New NOTES Interventions.

Sergey V Kantsevoy¹, Joseph Ramon Armengol-Miro²

¹University of Maryland School of Medicine, Baltimore, MD, USA; Institute for Digestive Health and Liver Diseases, Mercy Medical Center, 301 St. Paul Place, POB 7th Floor, Suite 718, Baltimore, MD 21202, USA; World Institute for Digestive Endoscopy (WIDER), Barcelona, Spain.

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Summary

Natural orifice transluminal endoscopic surgery (NOTES) offers a minimally invasive approach. This review covers endoscopic closure devices for NOTES, highlighting advanced suturing tools for reliable gastrointestinal defect repair.

Keywords:

Full-thickness resection Gastrointestinal tract Natural orifice transluminal endoscopic surgery (NOTES)

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Area of Science:

Minimally invasive surgery
Gastroenterology
Surgical device technology

Background:

Natural orifice transluminal endoscopic surgery (NOTES) is an emerging minimally invasive technique for intra-abdominal procedures.
Effective closure of the access site is crucial for the safety and success of NOTES procedures.
Various endoscopic devices have been developed for transluminal entrance site closure.

Purpose of the Study:

To review commonly used endoscopic closure devices in NOTES.
To highlight the advantages of the latest generation of endoscopic suturing devices.
To assess the reliability of these devices for full-thickness gastrointestinal wall closure.

Main Methods:

Literature review of endoscopic closure techniques for NOTES.
Analysis of device types and their application in animal models and clinical studies.
Evaluation of the efficacy and safety of different closure methods.

Main Results:

Several endoscopic closure devices are available for NOTES, including clips, sutures, and plugs.
Latest generation endoscopic suturing devices offer improved functionality and ease of use.
These advanced devices enable reliable, surgical-quality closure of full-thickness gastrointestinal defects.

Conclusions:

Endoscopic closure devices are essential for NOTES procedures.
Advanced endoscopic suturing devices provide a robust solution for closing NOTES access sites.
These innovations contribute to the advancement and wider adoption of NOTES surgery.