Natural orifice transluminal endoscopic surgery

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Abstract
The first natural orifice transluminal endoscopic surgery (NOTES) in a swine model was reported at Digestive Disease Week (DDW) in 2000 [1], and it has now been one decade since the first human case video demonstration [2]. Ten years later, the field is evolving and maturing. A range of procedures such as single-port surgery, hybrid surgery, endoscopic submucosal dissection (ESD), and per-oral endoscopic myotomy (POEM) are now often grouped under the NOTES umbrella though they may not use a natural orifice, and they may not be transluminal. POEM is considered by some to be the first sentinel application in NOTES [3]. Hybrid and submucosal approaches to upper gastrointestinal tumors in humans may spare major organ resection with life-long quality-of-life implications [4] [5] [6]. At DDW 2012 (19 – 22 May, San Diego, California, USA) data were presented on pure NOTES procedures performed using only conscious sedation [7], and percutaneous flexible endoscopy-based extraction of gallstones was demonstrated [8]. Although growth in the field is escaping strict definitions, the concept of NOTES continues to embolden progress on a host of clinical problems. At DDW 2012, there were 22 NOTES abstracts and 4 POEM abstracts, representing a steady level of research, following 26 abstracts in 2010 and 25 in 2011. The top 20 abstracts of 2012 are reviewed below.

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