Natural Orifice Transluminal Endoscopic Surgery NOTES

The term NOTES has been coined in 2006 by an American working group consisting of gastroenterologists and surgeons, after A. Kalloo has reported on the experience of transgastric peritoneoscopy in 2004. In the NOTES approach mouth, anus, vagina and uretha are used as a primary gateway to the abdominal cavity by endoscopes. Kalloo developed the idea of penetrating the gastric wall with a flexible scope, thus entering the peritoneal cavity and going to a different region within this cavity for diagnostic and therapeutic purposes. It is not known whether this new technology will have a similar impact on surgery like the advent of minimal invasive surgery. Gastroenterology and Surgery are both involved. The difficulty of the NOTES technique is remarkable and will be more complex than the original minimal access technique.