NOTES: current status and expectations

Abstract

Zusammenfassung. Grundlagen: Um die Größe von Hautinzisionen zu minimieren, hat sich die minimal invasive Chirurgie in den letzten Jahren weiterentwickelt. Der faszinierendste Schritt ist nun Natural Orifice Tranlumenal Endoscopic Surgery (NOTES), also endoskopische Chirurgie über natürliche Körperöffnungen. In dieser Arbeit wird der derzeitige Stand von NOTES evaluiert.Methodik: Ü bersicht zu NOTES. Ergebnisse: NOTES wird derzeit an Tiermodellen optimiert und findet auch schon Anwendung am Menschen. Die technische Herausforderung besteht in der Entwicklung von neuen, flexiblen, multifunktionalen Endoskopen und Instrumenten, um NOTES sicher, rasch und flexibel zu gestalten.Schlussfolgerungen: NOTES ist vielversprechend und wird die chirurgische Routine durch minimales operatives Trauma und schnelle Genesung revolutionieren. Die Zukunft wird ideale Anwendungen für NOTES zeigen.Schlüsselwörter: NOTES, Endoskopie, Chirurgie, minimal invasiv, Hybrid-Eingriff.Summary. Background: Surgeons are striving to minimize the surgical incisions. Minimal invasive surgery is progressing over the years. The most exciting move is Natural Orifice Transluminal Endoscopic Surgery. The aim of this article is to evaluate the current evolution and future prospects of natural orifice transluminal endoscopic surgery.Methods: Medline search was used for the published articles through March-May 2008 relevant to natural orifice transluminal endoscopic surgery. About 147 articles were published and 85 papers were selected for this review.Results: Extensive activities are on to study NOTES on animal models, to try NOTES on human beings, and to provide training, research and scientific meetings. Technical refinement to produce an ideal flexible scope and access closure devices is continuing to make NOTES procedures quick, safe and practical.Conclusions: The current NOTES situation is promising .We expect NOTES to refine current surgical practice to provide minimal operative and postoperative trauma and rapid recovery through useful clinical applications in the near future.Keywords: Natural orifice transluminal endoscopic surgery (NOTES), hybrid procedure, state of the art, minimal invasive surgery, endoscopy.

When "open" and "close" fail: Achalasia & GERD

“…In keeping with the recent topic on NOTES [12], this issue of European Surgery continues to inform you on novel trends and innovations regarding NOTES. I hope that this [11] and the recent articles on NOTES [12] will motivate you to contribute to the developments of the technique and its application to the patient. Enjoy reading and have a relaxing ''summer time blues'' (Fig.…”

“…Therefore, this issue of European Surgery includes a state-of-the-art review on NOTES. Hussain and Mashmood [11] summarize the current developments and applications of NOTES. In keeping with the recent topic on NOTES [12], this issue of European Surgery continues to inform you on novel trends and innovations regarding NOTES.…”

Modern orchestration of disease management

“…Going in line with recent contributions published in European Surgery on this fascinating technology [8], Spaun and Swanstrom summarize the state of the art and current applications of NOTES. It clearly comes out that NOTES demands to open your mind for a new understanding of the terms speciality and education.…”

Roboterassistierte laparoskopische Cardiomyotomie

“…Nevertheless, yearly follow-up of patients is recommended because of the increased risk of developing cancer and in order to detect any aggravation or recurrence of esophageal dilatation to avoid development of end-stage megaesophagus and the need for esophagectomy [19,20]. The future role of naturalorifice translumenal endoscopic surgery in the treatment of achalasia has to be awaited; some experimental studies are underway [21,22].…”