Eduardo M Targarona, Edgar Mauricio Maldonado, Jose Antonio Marzol, Franco Marinello, Department of Surgery, Hospital Santpau, Autonomous University of Barcelona, Sant Quinti 89, 08041 Barcelona, Spain.
World J Gastrointest Surg. 2010 Jun 27;2(6):179-86. doi: 10.4240/wjgs.v2.i6.179.
The advent of minimally invasive surgery and the advances in endoluminal flexible endoscopy have converged to generate a new concept in digestive surgery, whose acronym natural orifice transluminal endoscopic surgery (NOTES), has become a familiar term in the surgical community. NOTES has been performed through the mouth, the bladder, the rectum and the vagina. Of these four approaches, the vagina has gained most popularity for several reasons. It is not only readily accessible and easy to decontaminate but it also provides safe entry and simple closure. The transvaginal approach has been described in the experimental and the clinical setting as an option for cholecystectomy, nephrectomy, splenectomy, segmental gastrectomy, retroperitoneal exploration and bariatric surgery. However, larger series are needed to delineate the exact risks of this approach, and to transcend cultural barriers that impede its wider introduction. Prospective randomized trials will shed light on the definitive role of the vaginal approach in minimal invasive surgery of the future.
微创外科的出现和内镜下腔内技术的进步，共同催生了消化外科领域的新概念，即经自然腔道内镜手术（NOTES），这一缩写在外科领域已广为人知。NOTES 可经口、膀胱、直肠和阴道等自然腔道进行操作。这四种方法中，阴道入路由于多种原因而最受欢迎。阴道不仅易于接近和易于消毒，而且提供了安全的进入和简单的闭合途径。经阴道入路已在实验和临床环境中被描述为用于胆囊切除术、肾切除术、脾切除术、胃部分切除术、腹膜后探查术和减肥手术的一种选择。然而，需要更大的系列研究来明确这种方法的确切风险，并克服阻碍其更广泛应用的文化障碍。前瞻性随机试验将阐明阴道入路在未来微创外科中的明确作用。
