NOTES—third generation surgery. Vain hopes or the reality of tomorrow?

Abstract

NOTES is currently the subject of the intensive research. It seems like this is only the matter of time when a transluminal access to the abdominal or even thoracic cavity will become the reality. Moreover, this will enable the management of some diseases in a possibly minimally invasive pattern, nearly painless and leaving no scar at all.

Gastric wall healing after NOTES procedures: closure with endoscopic clips provides superior histological outcome compared with threaded tags closure

“…27,28 This objective has not been met yet, and most institutional review boards still require laparoscopic access to the peritoneal cavity to verify the quality of the endoscopic closure in any attempt to perform transgastric NOTES in human patients. 28 Multiple endoscopic devices have been previously used to close the transgastric access site after NOTES procedures. [17][18][19][20][21][22][23] However, the majority of previously reported studies have used either commercially available endoscopic clips or T-tags.…”

Mucoadhesive film for anchoring assistive surgical instruments in endoscopic surgery: in vivo assessment of deployment and attachment

“…Additionally, other techniques, such as natural orifices transluminal endoscopic surgery (NOTES) [19], may benefit from the use of purposely developed AISI attached to the inner gastric wall. Fundoplication, used in the treatment of gastroesophageal reflux disease (GERD) [20], is another procedure that may take advantage by mucoadhesive AISI.…”

The focus of Langenbeck’s Archives of Surgery in the 21st century

“…Indeed, current demographic development will require the implementation of surgical techniques that are suited to minimize the perioperative risks posed by agerelated comorbidity. Present efforts at achieving these goals are manifold and have led to continuous innovations in minimally invasive surgery, including the recent development of single-incision laparoscopic surgery [23], applying flexible endoscopes, or natural orifice translumenal endoscopic surgery [24]. The beneficial effect of such advances for improving the morbidity associated with elective surgical procedures will need to be followed up in the future, with particular respect to surgical outcomes in the elderly patient.…”