Endoscopic transcolonic techniques for NOTES

摘要

Over the past 100 years, there has been a gradual progression in the field of surgery from the traditional invasive open laparotomy to increasingly less invasive techniques of laparoscopy. In contrast, the field of gastrointestinal endoscopy has become increasing more interventional, with therapeutic endoscopists performing procedures previously only performed by surgeons, including transgastric pseudocyst drainage and transgastric endoscopic pancreatic debridement. Natural orifice translumenal endoscopic surgery (NOTES) appears to represent a convergence of the two fields of minimally invasive surgery and interventional endoscopy. NOTES is the performance of intra-abdominal interventions via an incisional opening through a natural orifice. Although initial studies were focused on the transgastric approach, there have been increasing numbers of NOTES procedures performed via other natural orifices, including transcolonic, transvaginal, and transvesical approaches. Although further research is needed before widespread clinical application of the NOTES techniques, it has the potential to revolutionize the fields of both minimally invasive surgery and interventional therapeutic endoscopy.