Sumiyama Kazuki, Gostout Christopher J, Gettman Matthew T
Department of Endoscopy, Jikei University School of Medicine, Tokyo, Japan.
J Endourol. 2009 May;23(5):765-71. doi: 10.1089/end.2008.0159.
Natural orifice translumenal endoscopic surgery (NOTES) is a novel surgical concept that may provide a multitasking platform for minimally invasive surgery in the 21st century. With NOTES, natural hollow organs are used to gain access to body cavities via the mouth, anus, vagina, and urethra, thereby eliminating skin incisions. Access to the body cavity through the entry portal for the NOTES procedure and closure of the portal after surgery are important treatment considerations. In this review, access and closure techniques for NOTES-related procedures are discussed. Technical descriptions for access are also described. Closure techniques using experimental and commercially available devices are also reviewed. Based on the experimental and early clinical experiences to date, the future of NOTES appears quite promising. Nonetheless, ongoing fundamental research is necessary to determine the safety and benefit of these procedures. While technical challenges are currently present, the issues are being resolved with the development of optimal instrumentation and techniques. We believe that once standardized safe and reliable access and closure techniques are established, a major shift in minimally invasive surgery will likely be inevitable.
自然腔道内镜手术（NOTES）是一种新颖的手术概念，可能为21世纪的微创手术提供一个多任务平台。借助NOTES，可利用天然中空器官通过口腔、肛门、阴道和尿道进入体腔，从而避免皮肤切口。通过NOTES手术的进入通道进入体腔以及术后封闭通道是重要的治疗考量因素。在本综述中，将讨论NOTES相关手术的进入和封闭技术。还将描述进入的技术说明。也会回顾使用实验性和市售设备的封闭技术。基于目前的实验和早期临床经验，NOTES的前景似乎相当广阔。尽管如此，仍需持续进行基础研究以确定这些手术的安全性和益处。虽然目前存在技术挑战，但随着最佳器械和技术的发展，这些问题正在得到解决。我们相信，一旦建立起标准化的安全可靠的进入和封闭技术，微创手术的重大变革可能将不可避免。
