经自然腔道内镜手术

在过去的几年中,内镜领域出现了一种新型介入操作-经自然腔道内镜手术(natural orifice transluminal endoscopic surgery,NOTES),这一创新的内镜操作是经由自然腔道(口腔、肛门、阴道等)进入腹腔进行各种诊断和治疗.同时,也可经由自然腔道进入胸腔等其他体腔进行内镜手术. 与传统的剖腹手术不同,经自然腔道内镜手术避免了腹壁的切口,并且能够给患者带来特殊的好处. 尽管仍有许多难点需要突破,经自然腔道内镜手术这一无疤痕,安全的微创手术方式必将快速发展. 本文就该项新型手术方式的发展历史,实验研究,临床应用及前景等作一综述.

Natural orifice transluminal endoscopic surgery

In the past few years,endoscopy has been enriched by a novel concept,natural orifice transluminal endoscopic surgery (NOTES). In this innovative endoscopic technique abdominal organs are approached through natural orifices (mouth,anus,and vagina) in order to perform intra-abdominal diagnostic and therapeutic procedures. Moreover,endoscope is inserted into preexisting orifices to access the other body cavities (i.e. thoracic cavity). Unlike standard surgical procedures,NOTES avoids the need for abdominal incision,and also offers specific advantages in selected patient populations. Although major barriers remain,the demand for a truly scarless,safe,and minimally invasive surgery will promote a rapid development of NOTES technology. This review aimed to elucidate the history,experimental study,clinical application of NOTES.