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Update in Natural Orifice Translumenal Endoscopic Surgery (NOTES)
Joern Bernhardt1, Sarah Sasse, Kaja Ludwig
1aDepartment of Diagnostic and Interventional Endoscopy bDepartment of Surgery, Medical Center Suedstadt, Rostock cDepartment of Gastroenterology, Henriettenstift, Hannover, Germany.
Current Opinion in Gastroenterology
|July 26, 2017
Summary
Natural orifice translumenal endoscopic surgery (NOTES) is advancing with hybrid techniques. Clinical applications include transanal, transvaginal, and transoral procedures, showing comparable results to traditional surgery.
Area of Science:
- Minimally invasive surgery
- Gastroenterology
- Surgical innovation
Background:
- Natural orifice translumenal endoscopic surgery (NOTES) represents a significant advancement in minimally invasive surgical techniques.
- The development of NOTES aims to reduce surgical trauma and improve patient recovery by utilizing internal body pathways for access.
Purpose of the Study:
- To present recent developments in Natural orifice translumenal endoscopic surgery (NOTES) procedures and technologies.
- To review the current clinical applications and outcomes of NOTES interventions.
Main Methods:
- Review of experimental studies and clinical settings focusing on NOTES procedures.
- Analysis of data from the German NOTES-Register and national performance in Switzerland.
- Examination of hybrid techniques and novel surgical approaches in NOTES.
Main Results:
- NOTES procedures are predominantly performed using hybrid techniques in both experimental and clinical settings.
- Transanal total mesorectal excision and transvaginal cholecystectomy demonstrate comparable outcomes to laparoscopic approaches.
- Transoral interventions, including thyroidectomies and mediastinoscopies, are emerging clinical applications.
Conclusions:
- NOTES procedures are utilized in animal experiments and clinical practice, though less frequently than conventional methods.
- Hybrid techniques, often involving rigid instruments, are currently the primary approach for NOTES procedures.
- Ongoing research focuses on implementing new surgical strategies and enhancing procedural training for NOTES.