“…However, the specific technological challenges imposed by this procedure surpass those already confronted. Figure 6 gathers the main constraints of the currently available flexible endoscopes and the requirements for new and improved instrumentation and surgical tool for NOTES (Swanstrom et al, 2005;Hagen et al, 2008;Cahill, 2010;Meadows and Chamberlain, 2010;Bardou et al, 2010;Dallemagne and Marescaux, 2010;Cho et al, 2011;Chelalli and Cao, 2013;Shah et al, 2009;Soler et al, 2012;Gyoo, 2013;Kaehler et al, 2013;ISO-8373, 2015).…”