Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan.
Surg Today. 2010 Oct;40(10):909-16. doi: 10.1007/s00595-010-4311-3. Epub 2010 Sep 25.
Natural orifice translumenal endoscopic surgery (NOTES) is a sophisticated form of endoscopic surgery whose use has recently spread rapidly around the world. Although hundreds of reports of animal studies and clinical cases about NOTES have been published since 2004, NOTES is still in the experimental phase. The formation of an iatrogenic incision in the lumenal wall of intraperitoneal organs is a major disadvantage of NOTES. No reliable technique for complete closure has yet been established, and this problem must be resolved before NOTES can be adopted as a routine clinical practice. Several devices for the closure of lumenal incisions in the stomach or colorectum have been developed, and their safety and usefulness have been examined in animal studies and clinical cases. Kyushu University has been involved in furthering the adoption of NOTES as a routine clinical practice, and the Kyushu University Training Center for Minimally Invasive Surgery holds training sessions on endoscopic surgical techniques for surgeons from all over Japan. Studies to develop a navigation system and robotic technology for use with NOTES are also in progress at Kyushu University. The further development of endoscopy-related technologies and equipment, such as robotic technology, is therefore essential to allow the safe, widespread adoption of pure NOTES.
经自然腔道内镜手术（NOTES）是一种复杂的内镜手术形式，近年来在全球范围内迅速普及。虽然自 2004 年以来已经发表了数百篇关于 NOTES 的动物研究和临床病例报告，但 NOTES 仍处于实验阶段。在腹腔内器官的腔壁上形成医源性切口是 NOTES 的主要缺点。目前尚未建立可靠的完全闭合技术，在 NOTES 被常规应用于临床实践之前，必须解决这个问题。已经开发出几种用于闭合胃或结直肠腔切口的装置，并在动物研究和临床病例中检查了它们的安全性和实用性。九州大学一直致力于将 NOTES 常规应用于临床实践，九州大学微创外科培训中心为来自日本各地的外科医生举办内镜手术技术培训课程。九州大学还在研究用于 NOTES 的导航系统和机器人技术。因此，进一步开发内窥镜相关技术和设备，如机器人技术，对于确保安全、广泛采用纯 NOTES 至关重要。
