© Georg Thieme Verlag KG Stuttgart · New York
Natural orifice transluminal endoscopic surgery (NOTES)
11 January 2010 (online)
Natural orifice transluminal endoscopic surgery (NOTES) is still a matter of scientific research, and indeed, the total number of peer-reviewed original papers published on NOTES has increased recently compared with previous years. This holds true for all types of NOTES-related research topics ([Fig. 1]).
In addition, various surgical procedures such as hybrid-NOTES, single-incision laparoscopic surgery (SILS), transvaginal surgery with rigid endoscopes, and transumbilical surgery with flexible endoscopes (E-NOTES), all of them adopting the concept of scarless surgery, have recently been integrated into clinical routine medicine, at least in highly specialized centers. The phrase ”NOTES” has become a trademark for innovative, minimally invasive surgery. Terminological standards have therefore been agreed on by various societies to avoid further confusion  . The present summary therefore includes only manuscripts covering the ”classical” NOTES approach, i. e. access via natural orifices (excluding the umbilicus) using only flexible instruments.
Fig. 1 The frequency of peer-reviewed articles on natural orifice transluminal endoscopic surgery (NOTES) from September 2008 to August 2009 (red column) compared with the same time period in the previous 2 years (blue column). Non-English publications are excluded.