Department of Urology, Mayo Clinic, Rochester, MN, USA.
BJU Int. 2010 Sep;106(6 Pt B):908-12. doi: 10.1111/j.1464-410X.2010.09668.x.
Over the past several years, surgeons have sought to develop techniques to decrease the morbidity of various procedures. As a result, an extensive array of progressively more minimally invasive techniques now exists in the urologist's armamentarium, including smaller ('mini') incisions, laparoscopic hand-assisted surgery, as well as pure laparoscopic and robotic approaches. Theoretically, smaller incisions result in decreased pain and subsequently accelerated convalescence postoperatively. Most recently, innovative surgeons across multiple surgical specialties have pioneered the concept of eliminating incisions altogether and operating through natural orifices, which has been termed natural orifice transluminal endoscopic surgery (NOTES). The improved cosmesis associated with a pure NOTES approach is an attractive option for patients undergoing invasive therapeutic and diagnostic procedures. NOTES has significant potential for use by urological surgeons, as evidenced by multiple studies demonstrating the feasibility of pure and hybrid NOTES procedures in cadaveric, animal and human subjects. The purpose of this paper is to review the rationale for NOTES in urological surgery, and to detail the current limitations of this new technique.
在过去的几年中，外科医生一直在寻求开发技术以降低各种手术的发病率。因此，泌尿科医生的治疗方法中现在存在着广泛的、不断发展的微创技术，包括更小的（“迷你”）切口、腹腔镜手助手术以及纯腹腔镜和机器人手术。从理论上讲，较小的切口会减轻疼痛，并随后加速术后恢复。最近，多个外科专业的创新外科医生开创了完全消除切口并通过自然孔道进行手术的概念，这被称为经自然腔道内镜手术（NOTES）。与纯 NOTES 方法相关的改善美容效果是对接受侵入性治疗和诊断程序的患者的一个有吸引力的选择。NOTES 在泌尿外科医生中的应用具有重要的潜力，这一点已被多项研究证明，这些研究表明在尸体、动物和人体标本中纯 NOTES 手术和混合 NOTES 手术的可行性。本文的目的是回顾 NOTES 在泌尿外科手术中的基本原理，并详细介绍该新技术的当前局限性。
