In natural orifice translumenal endoscopic surgery (NOTES) intentional puncture of one of the viscera (e.g., stomach, rectum, vagina, and urinary bladder) is made and an endoscope is used to access the abdominal cavity and perform an intra-abdominal operation. Early studies focused on feasibility, including such accomplishments as pure transgastric splenectomy and gastrojejunostomy. Contemporary studies are investigating the infectious and immunologic implications of NOTES and honing the tools and techniques required for complex abdominal operations.
Today NOTES has entered the clinical arena in quite a few cases The first clinical series of transgastric peritoneoscopy has recently been published; many groups are accumulating patients in studies of NOTES cholecystectomy, either via the transgastric or transvaginal route; and a series of transgastric appendectomies has been well publicized, yet they remains unpublished. Although clinically NOTES is gaining momentum, the field should remain in check while rigorous studies are performed and clinical trials are undertaken. The zeal for NOTES should not take precedence over the welfare of the patient.
Flexible transgastric peritoneoscopy: A novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 2004;60(1):114-17.
A primer on natural orifice transluminal endoscopic surgery: Building a new paradigm. Surg Innov 2006;13(2):86-93.
Infectious complications of natural orifice translumenal endoscopic surgery with percutaneous endoscopic gastrostomy tube closure: A quantitative bacteriologic study in the porcine model. Surg Endosc 2007;21(Supplement):S333.
ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery. Surg Endosc 2006;20(2):329-33.
Peroral transgastric endoscopic ligation of fallopian tubes with longterm survival in a porcine model. Gastrointest Endosc 2005;61(3):449-53.
Endoscopic gastrojejunostomy with survival in a porcine model. Gastrointest Endosc 2005;62(2):287-92.
Transgastric endoscopic splenectomy: Is it possible? Surg Endosc 2006;20(3):522-25.
Pilot study of the porcine uterine horn as an in vivo appendicitis model for development of endoscopic transgastric appendectomy. Gastrointest Endosc 2006;64(5):808-12.
Transcolonic endoscopic cholecystectomy: A NOTES survival study in a porcine model (with video). Gastrointest Endosc 2006;64(3):428-34.
Survival studies after endoscopic transgastric oophorectomy and tubectomy in a porcine model. Gastrointest Endosc 2006;63(3):473-78.