Natural-orifice transluminal endoscopic surgery (NOTES) in Europe: summary of the working group reports of the Euro-NOTES meeting 2010

Abstract

The fourth Euro-NOTES workshop took place in September 2010 and focused on enabling intensive scientific dialogue and interaction between participants to discuss the state of the practice and development of natural-orifice transluminal endoscopic surgery (NOTES) in Europe. Five working groups were formed, consisting of participants with varying scientific and medical backgrounds. Each group was assigned to an important topic: the correct strategy for dealing with bacterial contamination and related complications, the question of the ideal entry point and secure closure, interdisciplinary collaboration and indications, robotics and platforms, and matters related to training and education. This review summarizes consensus statements of the working groups to give an overview of what has been achieved so far and what might be relevant for research related to NOTES in the near future.

Single incision laparoscopic cholecystectomy (SILC) versus laparoscopic cholecystectomy (LC)—a matched pair analysis

“…"Pure NOTES" is not yet established in routine surgery to date; however, with the aim of reducing surgical trauma, hybrid NOTES could be a valuable option to bring NOTES into clinical practice. Recent studies have demonstrated hybrid NOTES cholecystectomy to be feasible and safe in routine clinical practice [5]. In contrast, single incision laparoscopic surgery has reached the level of limited clinical application.…”

Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy

“…Next to the general feasibility and safety of NOTES, educational aspects must be evaluated before the new technique can be introduced into clinical practice [19].…”

Interdisciplinary concept of design, actuation, control and vision computing of a laser-sintered single-port robot

“…In contrast to classical open surgery the surgeon faces the problem of limited dexterity regarding the control of the instruments in minimally invasive surgery. Especially during ESD, where only one single instrument can be used for active manipulation [7]. The ideal solution would be a system that allows the surgeon to control two instruments independently in order to oppose them.…”

“…The ideal solution would be a system that allows the surgeon to control two instruments independently in order to oppose them. This configuration is the so-called triangulation [7], [8]. …”