NOTES (Natural Orifice Translumenal Endoscopic Surgery) is an acronym for the latest wave in minimally invasive surgery, in which procedures will be done through a natural orifice like the mouth or the anus, leaving no scar on the outside of the body and offering a reduction in pain and healing times compared with open and even laparoscopic surgeries. The new field covers both procedures that are performed endoscopically within the lumens of organs—the bowel, the stomach, or the vagina, for example--that can be reached with scopes in a non-invasive manner (endolumenal approach), and even more revolutionary surgeries in which clinicians will breach the walls of those organs to access the peritoneal cavity or some other space in the body (translumenal approach).
Natural orifice surgery is attractive because it carries the usual benefits of reduced invasiveness compared with open surgery, chief of...