NOTES Companies Sing an Upbeat Tune

There was an almost dot-com-like euphoria about NOTES at 2007's annual meetings of endoscopists and surgeons. NOTES (natural orifice translumenal endoscopic surgery) is being described as a revolution in minimally invasive surgery, incisionless surgery, or at the very least, a major advance over laparoscopy. It represents a billion-dollar category not yet dominated by the companies that gained preeminence in the $4 billion worldwide laparoscopy market. But most companies in the area agree that the NOTES revolution isn't going to happen overnight. The challenge for today is to create products and technologies for procedures that can happen in high volume in the near term, while waiting for more advanced NOTES procedures to come about.