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Chirurgie 18. Februar 2014

Upper GI natural orifice translumenal endoscopic surgery: what is new?

Background: Natural orifice translumenal endoscopic surgery (NOTES) is an evolving field. The aim of this study was to assess recent developments in the upper gastrointestinal NOTES.

Methods: A MEDLINE, CINAHL and Science Direct search was made for all published English literature relevant to upper gastrointestinal NOTES between January 2009 and January 2013. A total of 769 articles were found, and 57 studies were selected for this review based on relevance.

Results: Upper gastrointestinal NOTES is evolving, with feasibility, safety and efficacy ensured for several operations. A total of 1,201 operations were reported on patients, of which 673 (56.03 %) were cholecystectomies. The number of patients in each study ranged between 1 and 551, with a median of 5 patients. A total of 504 operations were performed on animals to explore safety and feasibility of a wide spectrum of operations. The sample size of these studies ranged from 3 to 250, with a median of 10.

Conclusions: There is a continuous development and refinement of the NOTES technique, and modern technology is helping to perform demanding procedures. Cholecystectomy is the commonest NOTES operation on human subjects, whereas animal studies are testing the safety and feasibility of a spectrum of operations in different surgical fields.

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