J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 260KB） [Members Only]

J.Jpn. Surg. Soc.. 117(5): 376-380, 2016

Feature topic

NATURAL ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY

1) Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Japan
2) Department of Surgery, Hetsugi Hospital, Oita, Japan
3) President, Oita University, Yufu, Japan

Hidefumi Shiroshita1), Tsuyoshi Etoh1), Kazuhiro Yasuda2), Masafumi Inomata1), Seigo Kitano3)

The clinical application of natural orifice translumenal endoscopic surgery (NOTES) began in 2007, and several thousand patients worldwide have undergone the technique. In this review, we summarize and highlight the current status and future directions of NOTES. The most common procedures are cholecystectomy and appendectomy, mainly performed as hybrid NOTES through the transvaginal route. In addition, direct-target NOTES such as per oral endoscopic myotomy (POEM) or transanal total mesorectal excision has spread rapidly, because it allows access to the operative field without injuring healthy visceral organs. In Japan, a clinical registration system was established, and clinical applications are carried out safely. NOTES performed in Japan is characterized by procedures requiring extensive techniques of endoscopic treatment such as endoscopic full-thickness resection, POEM, and the submucosal tunnel method. It will be necessary to develop instruments and determine social needs to achieve pure NOTES. It will also be necessary to determine the significance of reducing surgical wounds on the body surface. Although much work is still needed to refine the techniques for NOTES, it appears to be developing as a new minimally invasive form of surgical and endoscopic treatment.

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