SpringerLink
Log in

Natural Orifice Translumenal Endoscopic Surgery (NOTES™)

  • Chapter
  • First Online:
The SAGES Manual Operating Through the Endoscope

Abstract

Natural orifice translumenal endoscopic surgery (NOTES) is the application of using the body’s natural orifices in a transvisceral approach in order to access the body cavities and perform surgical interventions. NOTES aims to eliminate body incisions which allows for potentially decreased pain, expedited recovery, and avoidance of incisional scar formation, hernias, adhesions, and wound infections. This chapter focuses on the natural evolution and current NOTES procedures that utilize a transesophageal, transgastric, transvaginal, and transanal approach. Lastly, we discuss ongoing technical difficulties and the future of NOTES.

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

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Wilk PJ. Method for use in intra-abdominal surgery. US Patent. 1994;5:297–536.

    Google Scholar 

  2. Kalloo AN, Singh VN, Jagannath SB, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7.

    Article  PubMed  Google Scholar 

  3. Jagannath SB, et al. Peroral transgastric endoscopic ligation of fallopian tubes with long term survival in a porcine model. Gastrointest Endosc. 2005;61:449–53.

    Article  PubMed  Google Scholar 

  4. Rao G, Reddy N. Transgastric appendectomy in humans. In: Oral presentation at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) conference. 26 & 29 April 2006, Dallas, Texas

    Google Scholar 

  5. ASGE/SAGES Workign Group on Natural Orifice. Translumen Endoscopic Surgery White Paper 2005. Gastrointest Endosc. 2006;63:199–203.

    Google Scholar 

  6. Khashab MA, Kalloo AN. NOTES: current status and new horizons. Gastroenterology. 2012;142:704–10.

    Article  PubMed  Google Scholar 

  7. Liu L, Chiu PWY, Reddy N, et al. Natural orifice transluminal endoscopic surgery (NOTES) for clinical management of intra-abdominal diseases. Dig Endosc. 2013;25:565–77.

    Article  PubMed  Google Scholar 

  8. Garud SS, Willingham FF. Natural orifice transluminal endoscopic surgery. Gastrointest Endosc. 2012;76:491–5.

    Article  CAS  PubMed  Google Scholar 

  9. Sumiyama K, Gostout CJ, Rajan E, Bakken A, Knipschield MA. Transesophageal mediastinoscopy by submucosal endoscopy with mucosal flap safety valve technique. Gastrointest Endosc. 2007;65:679–83.

    Article  PubMed  Google Scholar 

  10. Pasricha PJ, Hawari R, Ahmed I, et al. Submucosal endoscopic esophageal myotomy: a novel experimental approach for the treatment of achalasia. Endoscopy. 2007;39:761–5.

    Article  CAS  PubMed  Google Scholar 

  11. Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42:265–71.

    Article  CAS  PubMed  Google Scholar 

  12. Bhayani NH, Kurian AA, Dunst CM, et al. A comparative study on comprehensive, objective outcomes of laparoscopic Heller myotomy with per-oral endoscopic myotomy (POEM) for achalasia. Ann Surg. 2014;259:1098–103.

    Article  PubMed  Google Scholar 

  13. Fritscher-Ravens A, Patel K, Ghanbari A, et al. Natural orifice transluminal endoscopic surgery (NOTES) in the mediastinum: Long term survival animal experiments in transesophageal access, including minor surgical procedures. Endoscopy. 2007;39:870–5.

    Article  CAS  PubMed  Google Scholar 

  14. Willingham FF, Gee DW, Lauwers GY, Brugge WR, Rattner DW. Natural orifice transesophageal mediastinoscopy and thoracoscopy. Surg Endosc. 2008;22:1042–7.

    Article  CAS  PubMed  Google Scholar 

  15. Gee DW, Rattner DW. Transmediastinal endoscopic intervention. J Gastrointest Surg. 2011;15:1303–5.

    Article  PubMed  Google Scholar 

  16. Trad KS. Transoral incisionless fundoplication: current status. Curr Opin Gastroenterol. 2016;32:338–43.

    Article  Google Scholar 

  17. Hakansson B, Montgomery M, Cadiere GB, et al. Randomized clinical trial: transoral incisionless fundoplication vs. sham intervention to control chronic GERD. Aliment Pharmacol Ther. 2015;42:1261–70.

    Article  CAS  PubMed  Google Scholar 

  18. Testoni PA, Testoni S, Mazzoleni G, et al. Long term efficacy of transoral incisionless fundoplication with Esophyx (Tif 2.0) and factors affecting outcomes in GERD patients followed for up to 6 years: a prospective single center study. Surg Endosc. 2015;29(2770):2780.

    Google Scholar 

  19. Sohn DK, Turner BG, Gee DW, et al. Reducing the unexpectedly high rate of injuries caused by NOTES gastrotomy creation. Surg Endosc. 2010;24:277–82.

    Article  PubMed  Google Scholar 

  20. Traverso LW, Kozarek RA. Pancreatic necrosectomy: definitions and technique. J Gastrointest Surg. 2005;9:436–9.

    Article  PubMed  Google Scholar 

  21. Connor S, Alexakis N, Raraty MG, et al. Early and late complications after pancreatic necrosectomy. Surgery. 2005;137:499–505.

    Article  CAS  PubMed  Google Scholar 

  22. Voermans RP, Bruno MJ, van Berge Henegouwen MI, Fockens P. Review Article: Translumenal endoscopic debridement of organized pancreatic necrosis—the first step towards natural orifice translumenal endoscopic surgery. Aliment Pharmacol Ther. 2007;26:233–9.

    Article  PubMed  Google Scholar 

  23. Van Brunschot S, Hollemans RA, Bakker OJ, et al. Minimally invasive and endoscopic versus open necrosectomy for necrotising pancreatitis: a pooled analysis of individual data for 1980 patients. Gut. 2018;67:697–706.

    PubMed  Google Scholar 

  24. Brown AM, Pryor AD, Docimo S Jr. Per oral pyloromyotomy utilizing a lesser curvature approach: how we do it. Surg Endosc. 2020;34:5168–71.

    Article  PubMed  Google Scholar 

  25. Juza RM, Docimo S, Sandoval V, et al. Endoscopic rescue of early percutaneous endoscopic gastrotomy tube dislodgement. Surg Endosc. 2021;35(4):1915–20.

    Article  CAS  PubMed  Google Scholar 

  26. Memark VS, Anderson JB, Nau PN, et al. Transgastric endoscopic peritoneoscopy does not lead to increased risk of infectious complications. Surg Endosc. 2011;25:2186–91.

    Article  PubMed  Google Scholar 

  27. Donatsky AM, Jorgensen LN, Meisner S, et al. Sexual function after transvaginal cholecystectomy: a systematic review. Surg Laparosc Endosc Percutan Tech. 2014;24:290–5.

    Article  PubMed  Google Scholar 

  28. Bernhardt J, Gerber B, Schober HC, Kaehler G, Ludwig K. NOTES-case report of a unidirectional flexible appendectomy. Int J Colorectal Dis. 2008;23:547–50.

    Article  PubMed  Google Scholar 

  29. Kaouk JH, White WM, Goel RK, et al. NOTES transvaginal nephrectomy: first human experience. Urology. 2009;74:5–8.

    Article  PubMed  Google Scholar 

  30. Bulian DR, Knuth J, Cerasani N, et al. Transvaginal/transumbilical hybrid-NOTES- versus 3-trocar needlescopic cholecystectomy: short-term results of a randomized clinical trial. Ann Surg. 2013;00:1–8.

    Google Scholar 

  31. Lee CL, Wu KU, Su H, et al. Transvaginal natural orifice transluminal endoscopic surgery (NOTES) in adnexal procedures. J Minim Invasive Gynecol. 2012;19:509–13.

    Article  PubMed  Google Scholar 

  32. Yang YS, Hur MH, Oh KY, Kim SY. Transvaginal natural orifice transluminal endoscopic surgery for adnexal masses. J Obstet Gynaecol Res. 2013;39:1604–9.

    Article  PubMed  Google Scholar 

  33. Wang CJ, Wu PY, Kuo HH, Yu HT, Huang CY, Tseng HT. Natural orifice transluminal endoscopic surgery assisted versus laparoscopic ovarian cystectomy (NAOC vs LOC): a case matched study. Surg Endosc. 2016;30:1227–34.

    Article  PubMed  Google Scholar 

  34. Su H, Yen CF, Wu KY, Han CM, Lee CL. Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES): feasibility of an innovative approach. Taiwan J Obstet Gynecol. 2012;51:217–21.

    Article  PubMed  Google Scholar 

  35. Buess G, Kipfmuller K, Hack D, Grussner R, et al. Technique of transanal endoscopic microsurgery. Surg Endosc. 1988;2:71–5.

    Article  CAS  PubMed  Google Scholar 

  36. de Lacy AM, Rattner DW, Adelsdorfer C, et al. Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: “down-to-up” total mesorectal excision (TME)—short-term outcomes in the first 20 cases. Surg Endosc. 2013;27:3165–72.

    Article  PubMed  Google Scholar 

  37. Ahlenstiel G, Hourigan LF, Brown G, et al. Actual endoscopic versus predicted surgical mortality for treatment of advanced mucosal neoplasia of the colon. Gastrointest Endosc. 2014;80:668–76.

    Article  PubMed  Google Scholar 

  38. Moss A, Williams SJ, Hourigan LF, et al. Long term adenoma recurrence following wide field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study. Gut. 2015;64:57–65.

    Article  PubMed  Google Scholar 

  39. Fujiya M, Tanaka K, Dokoshi T, et al. Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection. Gastrointest Endosc. 2015;81:583–95.

    Article  PubMed  Google Scholar 

  40. Sylla P, Bordeianou LG, Berger D, et al. A pilot study of natural orifice transanal endoscopic total mesorectal excision with laparoscopic assistance for rectal cancer. Surg Endosc. 2013;27:3396–405.

    Article  PubMed  Google Scholar 

  41. Hwang M, Kwon DS. K-FLEX: a flexible robotic platform for scar free endoscopic surgery. Int J Med Robot. 2020;16:e2078.

    Article  PubMed  Google Scholar 

  42. Visconti TA, Otoch JP, Artifon EL. Robotic Endoscopy. Acta Cir Bras: A review of literature; 2020. p. 35.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Stony Brook Medicine, Stony Brook, NY, USA

    Heitham Wady

  2. Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook Medicine, Stony Brook, NY, USA

    Salvatore Docimo Jr

Authors
  1. Heitham Wady
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Salvatore Docimo Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Heitham Wady .

Editor information

Editors and Affiliations

  1. Digestive Disease Inst, A100, Cleveland Clinic, Cleveland, OH, USA

    Matthew Kroh

  2. Department of Surgery, University of South Florida, Tampa, FL, USA

    Salvatore Docimo Jr.

  3. BariJuve Surgical, Hoffman Estates, IL, USA

    Sofiane El Djouzi

  4. Department of Surgery, University of Wisconsin Health, Madison, WI, USA

    Amber Shada

  5. Center for Advanced Surgery, The Oregon Clinic, Portland, OR, USA

    Kevin M. Reavis

Rights and permissions

Reprints and permissions

Copyright information

© 2023 SAGES

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wady, H., Docimo, S. (2023). Natural Orifice Translumenal Endoscopic Surgery (NOTES™). In: Kroh, M., Docimo Jr., S., El Djouzi, S., Shada, A., Reavis, K.M. (eds) The SAGES Manual Operating Through the Endoscope. Springer, Cham. https://doi.org/10.1007/978-3-031-21044-0_44

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-21044-0_44

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-21043-3

  • Online ISBN: 978-3-031-21044-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation