Natural orifice translumenal endoscopic surgery (NOTES) conclusions

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Editor-In-Chief: Mohammed A. Sbeih, M.D. [mailto:msbeih@perfuse.org] Phone:617-849-2629

Synonyms and keywords: Natural orifice translumenal endoscopic surgery, Single incision laparoscopic surgery, Minimally invasive surgery, Transanal endoscopic microsurgery, Natural orifice surgery consortium for assessment and research, Society of american gastrointestinal and endoscopic surgeons.

Natural Orifice Translumenal Endoscopic Surgery (NOTES) Conclusions
Natural orifice transluminal surgery (NOTES) is a rapidly evolving field which may shift the minimally invasive surgery world from laparoscopic surgery and video assisted thoracic surgery to procedures that can be done through the natural body orifices without any abdominal or thoracic incisions. NOTES may be a feasible, safe, and reasonable option for abdominal surgery. It may provide many advantages and lessen surgical complications. New NOTES procedures should be experimental at the beginning, and they should be performed only in research labs in advanced institutions before being applied clinically.

We are on the way to apply many NOTES procedures clinically by the steady progression in the field. Patient safety and research trials that ensure this safety are paramount. Innovative instruments are needed by the surgeons and gastroenterologists to perform safe NOTES procedures. The development of such therapeutic techniques and advanced endoscopic devices will allow the endoscopists to perform various procedures more easily, such as resection of large and deep mucosal lesions and taking full thickness biopsies.

International NOTES research groups, such as NOSCAR, EURO-NOTES, ASIA-NOTES, NOSLA (Natural Orifice Surgery Latin America), EATS (European Association of Translumenal Surgery) and others are currently working to improve the NOTES field and aim to provide worldwide registries for NOTES procedures.

Finally, enthusiasm and conducting laboratory studies and clinical trials are required for further improvements in the field in order to provide the best possible patient care.