Skip to main content
Log in

Current progress on natural orifice transluminal endoscopic surgery (NOTES)

  • Review
  • Published:
Frontiers of Medicine Aims and scope Submit manuscript

Abstract

Natural orifice transluminal endoscopic surgery (NOTES) has received considerable interest in recent years as a novel surgical technique. Here, we aim to review the current progress on NOTES, particularly focusing on the advantages and complications related to NOTES, the recent advances of surgical approaches, new instruments for closure of the natural orifice incision, and the newly developed platform for NOTES. Finally, we make a prediction of the conceivable applications of NOTES on human subjects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA, Kantsevoy SV. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 2004; 60(1): 114–117

    Article  PubMed  Google Scholar 

  2. Ponsky JL. Endoluminal surgery: past, present and future. Surg Endosc 2006; 20(Suppl 2): S500–S502

    Article  PubMed  Google Scholar 

  3. Arulampalam T, Patterson-Brown S, Morris AJ, Parker MC. Consensus statement: natural orifice transluminal endoscopic surgery. Ann R Coll Surg Engl 2009; 91(6): 456–459

    Article  PubMed  CAS  Google Scholar 

  4. Rattner DW, Hawes R. What is NOSCAR? Surg Endosc 2007; 21(7): 1045–1046

    Article  PubMed  Google Scholar 

  5. Bergström M, Ikeda K, Swain P, Park PO. Transgastric anastomosis by using flexible endoscopy in a porcine model (with video). Gastrointest Endosc 2006; 63(2): 307–312

    Article  PubMed  Google Scholar 

  6. Park PO, Bergström M, Ikeda K, Fritscher-Ravens A, Swain P. Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis (videos). Gastrointest Endosc 2005; 61(4): 601–606

    Article  PubMed  Google Scholar 

  7. Ko CW, Kalloo AN. Per-oral transgastric abdominal surgery. Chin J Dig Dis 2006; 7(2): 67–70

    Article  PubMed  Google Scholar 

  8. Bernhardt J, Gerber B, Schober HC, Kähler G, Ludwig K. NOTES-case report of a unidirectional flexible appendectomy. Int J Colorectal Dis 2008; 23(5): 547–550

    Article  PubMed  Google Scholar 

  9. Kantsevoy SV, Jagannath SB, Niiyama H, Chung SS, Cotton PB, Gostout CJ, Hawes RH, Pasricha PJ, Magee CA, Vaughn CA, Barlow D, Shimonaka H, Kalloo AN. Endoscopic gastrojejunostomy with survival in a porcine model. Gastrointest Endosc 2005; 62(2): 287–292

    Article  PubMed  Google Scholar 

  10. Kantsevoy SV, Hu B, Jagannath SB, Vaughn CA, Beitler DM, Chung SS, Cotton PB, Gostout CJ, Hawes RH, Pasricha PJ, Magee CA, Pipitone LJ, Talamini MA, Kalloo AN. Transgastric endoscopic splenectomy: is it possible? Surg Endosc 2006; 20(3): 522–525

    Article  PubMed  CAS  Google Scholar 

  11. Perretta S, Dallemagne B, Allemann P, Marescaux J. Multimedia manuscript. Heller myotomy and intraluminal fundoplication: a NOTES technique. Surg Endosc 2010; 24(11): 2903

    Article  PubMed  Google Scholar 

  12. Jagannath SB, Kantsevoy SV, Vaughn CA, Chung SS, Cotton PB, Gostout CJ, Hawes RH, Pasricha PJ, Scorpio DG, Magee CA, Pipitone LJ, Kalloo AN. Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model. Gastrointest Endosc 2005; 61(3): 449–453

    Article  PubMed  Google Scholar 

  13. Wagh MS, Merrifield BF, Thompson CC. Survival studies after endoscopic transgastric oophorectomy and tubectomy in a porcine model. Gastrointest Endosc 2006; 63(3): 473–478

    Article  PubMed  Google Scholar 

  14. Isariyawongse JP, McGee MF, Rosen MJ, Cherullo EE, Ponsky LE. Pure natural orifice transluminal endoscopic surgery (NOTES) nephrectomy using standard laparoscopic instruments in the porcine model. J Endourol 2008; 22(5): 1087–1091

    Article  PubMed  Google Scholar 

  15. Bowman DE. ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery White Paper October 2005. Gastrointest Endosc 2006; 63(2): 199–203

    Article  Google Scholar 

  16. Flora ED, Wilson TG, Martin IJ, O’Rourke NA, Maddern GJ. A review of natural orifice translumenal endoscopic surgery (NOTES) for intra-abdominal surgery: experimental models, techniques, and applicability to the clinical setting. Ann Surg 2008; 247(4): 583–602

    Article  PubMed  Google Scholar 

  17. Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg 2005; 189(4): 395–404

    Article  PubMed  Google Scholar 

  18. McGee MF, Rosen MJ, Marks J, Onders RP, Chak A, Faulx A, Chen VK, Ponsky J. A primer on natural orifice transluminal endoscopic surgery: building a new paradigm. Surg Innov 2006; 13(2): 86–93

    Article  PubMed  Google Scholar 

  19. O’Dwyer PJ, Courtney CA. Factors involved in abdominal wall closure and subsequent incisional hernia. Surgeon 2003; 1(1): 17–22

    Article  PubMed  Google Scholar 

  20. Zhang L, Li Q, Qin J, Gu Y. Musculature tissue engineering to repair abdominal wall hernia. Artif Organs 2012; 36(4): 348–352

    Article  PubMed  Google Scholar 

  21. Puzziferri N, Austrheim-Smith IT, Wolfe BM, Wilson SE, Nguyen NT. Three-year follow-up of a prospective randomized trial comparing laparoscopic versus open gastric bypass. Ann Surg 2006; 243(2): 181–188

    Article  PubMed  Google Scholar 

  22. Menzies D, Ellis H. Intestinal obstruction from adhesions-how big is the problem? Ann R Coll Surg Engl 1990; 72(1): 60–63

    PubMed  CAS  Google Scholar 

  23. Fong DG, Pai RD, Thompson CC. Transcolonic endoscopic abdominal exploration: a NOTES survival study in a porcine model. Gastrointest Endosc 2007; 65(2): 312–318

    Article  PubMed  Google Scholar 

  24. McGee MF, Marks JM, Onders RP, Chak A, Jin J, Williams CP, Schomisch SJ, Ponsky JL. Complete endoscopic closure of gastrotomy after natural orifice translumenal endoscopic surgery using the NDO Plicator. Surg Endosc 2008; 22(1): 214–220

    Article  PubMed  CAS  Google Scholar 

  25. Woodward T, McCluskey D 3rd, Wallace MB, Raimondo M, Mannone J, Smith CD. Pilot study of transesophageal endoscopic surgery: NOTES esophagomyotomy, vagotomy, lymphadenectomy. J Laparoendosc Adv Surg Tech A 2008; 18(5): 743–745

    Article  PubMed  Google Scholar 

  26. Elmunzer BJ, Schomisch SJ, Trunzo JA, Poulose BK, Delaney CP, McGee MF, Faulx AL, Marks JM, Ponsky JL, Chak A. EUS in localizing safe alternate access sites for natural orifice transluminal endoscopic surgery: initial experience in a porcine model. Gastrointest Endosc 2009; 69(1): 108–114

    Article  PubMed  Google Scholar 

  27. Fritscher-Ravens A, Ghanbari A, Cuming T, Kahle E, Niemann H, Koehler P, Patel K. Comparative study of NOTES alone vs. EUSguided NOTES procedures. Endoscopy 2008; 40(11): 925–930

    Article  PubMed  CAS  Google Scholar 

  28. Pai RD, Fong DG, Bundga ME, Odze RD, Rattner DW, Thompson CC. Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model (with video). Gastrointest Endosc 2006; 64(3): 428–434

    Article  PubMed  Google Scholar 

  29. Wilhelm D, Meining A, von Delius S, Fiolka A, Can S, Hann von Weyhern C, Schneider A, Feussner H. An innovative, safe and sterile sigmoid access (ISSA) for NOTES. Endoscopy 2007; 39(5): 401–406

    Article  PubMed  CAS  Google Scholar 

  30. Branco F, Pini G, Osório L, Cavadas V, Versos R, Gomes M, Autorino R, Correia-Pinto J, Lima E. Transvesical peritoneoscopy with rigid scope: feasibility study in human male cadaver. Surg Endosc 2011; 25(6): 2015–2019

    Article  PubMed  Google Scholar 

  31. Chiu PW, Wai Ng EK, Teoh AY, Lam CC, Lau JY, Sung JJ. Transgastric endoluminal gastrojejunostomy: technical development from bench to animal study (with video). Gastrointest Endosc 2010; 71(2): 390–393

    Article  PubMed  Google Scholar 

  32. Yoshizumi F, Yasuda K, Kawaguchi K, Suzuki K, Shiraishi N, Kitano S. Submucosal tunneling using endoscopic submucosal dissection for peritoneal access and closure in natural orifice transluminal endoscopic surgery: a porcine survival study. Endoscopy 2009; 41(8): 707–711

    Article  PubMed  CAS  Google Scholar 

  33. Sumiyama K, Gostout CJ, Rajan E, Bakken TA, Knipschield MA, Chung S, Cotton PB, Hawes RH, Kalloo AN, Kantsevoy SV, Pasricha PJ. Transgastric cholecystectomy: transgastric accessibility to the gallbladder improved with the SEMF method and a novel multibending therapeutic endoscope. Gastrointest Endosc 2007; 65(7): 1028–1034

    Article  PubMed  Google Scholar 

  34. Pauli EM, Haluck RS, Ionescu AM, Rogers AM, Shope TR, Moyer MT, Biswas A, Mathew A. Directed submucosal tunneling permits in-line endoscope positioning for transgastric natural orifice translumenal endoscopic surgery (NOTES). Surg Endosc 2010; 24(6): 1474–1481

    Article  PubMed  Google Scholar 

  35. Merrifield BF, Wagh MS, Thompson CC. Peroral transgastric organ resection: a feasibility study in pigs. Gastrointest Endosc 2006; 63(4): 693–697

    Article  PubMed  Google Scholar 

  36. Ryou M, Fong DG, Pai RD, Rattner DW, Thompson CC. Transluminal closure for NOTES: an ex vivo study comparing leak pressures of various gastrotomy and colotomy closure modalities. Endoscopy 2008; 40(5): 432–436

    Article  PubMed  CAS  Google Scholar 

  37. Voermans RP, van Berge Henegouwen MI, Bemelman WA, Fockens P. Novel over-the-scope-clip system for gastrotomy closure in natural orifice transluminal endoscopic surgery (NOTES): an ex vivo comparison study. Endoscopy 2009; 41(12): 1052–1055

    Article  PubMed  CAS  Google Scholar 

  38. Rolanda C, Lima E, Silva D, Moreira I, Pêgo JM, Macedo G, Correia-Pinto J. In vivo assessment of gastrotomy closure with overthe-scope clips in an experimental model for varicocelectomy (with video). Gastrointest Endosc 2009; 70(6): 1137–1145

    Article  PubMed  Google Scholar 

  39. Chiu PW, Lau JY, Ng EK, Lam CC, Hui M, To KF, Sung JJ, Chung SS. Closure of a gastrotomy after transgastric tubal ligation by using the Eagle Claw VII: a survival experiment in a porcine model (with video). Gastrointest Endosc 2008; 68(3): 554–559

    Article  PubMed  Google Scholar 

  40. Sumiyama K, Gostout CJ, Rajan E, Bakken TA, Knipschield MA, Marler RJ. Submucosal endoscopy with mucosal flap safety valve. Gastrointest Endosc 2007; 65(4): 688–694

    Article  PubMed  Google Scholar 

  41. Perretta S, Sereno S, Forgione A, Dallemagne B, Coumaros D, Boosfeld C, Moll C, Marescaux J. A new method to close the gastrotomy by using a cardiac septal occluder: long-term survival study in a porcine model. Gastrointest Endosc 2007; 66(4): 809–813

    Article  PubMed  Google Scholar 

  42. Spaun GO, Zheng B, Martinec DV, Cassera MA, Dunst CM, Swanström LL. Bimanual coordination in natural orifice transluminal endoscopic surgery: comparing the conventional dual-channel endoscope, the R-Scope, and a novel direct-drive system. Gastrointest Endosc 2009; 69(6): e39–e45

    Article  PubMed  Google Scholar 

  43. Spaun GO, Zheng B, Swanstrom LL. A multitasking platform for natural orifice translumenal endoscopic surgery (NOTES): a benchtop comparison of a new device for flexible endoscopic surgery and a standard dual-channel endoscope. Surg Endosc 2009; 23(12): 2720–2727

    Article  PubMed  Google Scholar 

  44. Thompson CC, Ryou M, Soper NJ, Hungess ES, Rothstein RI, Swanstrom LL. Evaluation of a manually driven, multitasking platform for complex endoluminal and natural orifice transluminal endoscopic surgery applications (with video). Gastrointest Endosc 2009; 70(1): 121–125

    Article  PubMed  Google Scholar 

  45. Park PO, Long GL, Bergström M, Cunningham C, Vakharia OJ, Bakos GJ, Bally KR, Rothstein RI, Swain CP. A randomized comparison of a new flexible bipolar hemostasis forceps designed principally for NOTES versus a conventional surgical laparoscopic bipolar forceps for intra-abdominal vessel sealing in a porcine model. Gastrointest Endosc 2010; 71(4): 835–841

    Article  PubMed  Google Scholar 

  46. Fritscher-Ravens A, Ghanbari A, Holland C, Olagbeye F, Hardeler KG, Seehusen F, Jacobsen B, Mannur K. Beyond NOTES: randomized controlled study of different methods of flexible endoscopic hemostasis of artificially induced hemorrhage, via NOTES access to the peritoneal cavity. Endoscopy 2009; 41(1): 29–35

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Lu Zhang or Weize Wu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, J., Zhang, L. & Wu, W. Current progress on natural orifice transluminal endoscopic surgery (NOTES). Front. Med. 6, 187–194 (2012). https://doi.org/10.1007/s11684-012-0198-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11684-012-0198-2

Keywords

Navigation