NOTES - Natural Orifice Transluminal Endoscopic Surgery

Natural Orifice Transluminal Endoscopic Surgery (NOTES) may provide the entry point for surgical interventions in the peritoneal cavity, thereby avoiding abdominal wall incisions. It allows the problems connected with postoperative wounds to be avoided. These operations require expertise in laparoscopic surgery and flexible endoscopy. Currently we can use three accesses to the peritoneal cavity: transgastric, transvaginol and transcolonic route. The problems that remain are: maintenance of adequate intraabdominal pressure, the strength of the gastrotomy closure, and management of intraperitoneal complications such as bleeding, bowel perforation and splenic injury. NOTES could offer significant benefits to patients such as less pain, foster recovery and better cosmetic effects than current laparoscopic techniques. According to SAGES the era of the laparoscopic revolution is over, the era of Natural Orifice Transluminal Endoscopic Surgery is coming.