NOTES—third generation surgery. Vain hopes or the reality of tomorrow? |
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Authors: | Jarek Kobiela Tomasz Stefaniak Malgorzata Mackowiak Andrzej J Lachinski Zbigniew Sledzinski |
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Institution: | (1) Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 7 Debinki Str., 80-211 Gdansk, Poland |
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Abstract: | Background Laparoscopic approach has made many procedures less invasive; however, it seems like this is not enough. The newest challenge
for the medical environment is applying the scarless surgery in humans. In this article, we review the origin, current state
of art, and future of natural orifice transluminal endoscopic surgery (NOTES). The registered base of research in humans is
yet scarce; however, the porcine model experimental studies hold a great promise. In NOTES, peritoneal cavity can be easily
achieved, and some procedures are feasible through the natural orifices like digestive tract, vagina, or urinary bladder.
If safety and advantages of these approaches will be proven beyond question, NOTES procedures are likely to be adapted in
humans after overcoming the critical obstacles, like reliable closure methods, indispensable equipment invention, the multidisciplinary
specialists training, etc. The aim of this article was to review available literature to provide current state of art in NOTES
surgery.
Materials and methods Medical databases were searched for animal and human experience with NOTES to give an overview of history, current state of
art, and future of this technique.
Results NOTES is currently the subject of the intensive research. It seems like this is only the matter of time when a transluminal
access to the abdominal or even thoracic cavity will become the reality. Moreover, this will enable the management of some
diseases in a possibly minimally invasive pattern, nearly painless and leaving no scar at all. |
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Keywords: | NOTES Natural orifice transluminal endoscopic surgery Laparoscopic surgery Endoscopy |
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