Ullah Saif, Ali Faisal S, Liu Bing-Rong
Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Internal Medicine, Saint Joseph Hospital, Chicago, Illinois, USA.
Curr Opin Gastroenterol. 2021 Sep 1;37(5):470-477. doi: 10.1097/MOG.0000000000000753.
This review is an update on the recent advancements and clinical applications of flexible endoscopy in the context of natural orifice translumenal endoscopic surgery (NOTES). We focus on recent developments in gastrointestinal luminal and transluminal NOTES.
NOTES has evolved from a hybrid approach utilizing a laparoscopic assistant to pure NOTES without laparoscopic assistance. Current experimental and clinical studies focus on the implementation of new minimally invasive approaches as well as on the training in the use of these procedures. In recent years, flexible endoscopic-NOTES and endoluminal surgery have increasingly reported favorable results in preclinical and experimental settings using flexible endoscopic cholecystectomy, cholecystolithotomy, and appendectomy. Additionally, flexible endoscopic lymphadenectomy and thyroidectomy are among the new interventions that are opening new frontiers for endoscopists to explore.
Flexible endoscopy has paved way to new frontiers for endoscopists and surgeons. As the armamentarium of interventional endoscopy increases and the ability of endoscopists to perform advanced interventions safely fosters an inevitable step forward that will involve the integration of new technology with innovative thinking.
本综述旨在更新自然腔道内镜手术（NOTES）背景下柔性内镜的最新进展及临床应用。我们重点关注胃肠道腔内及经腔NOTES的近期发展。
NOTES已从利用腹腔镜辅助的混合方法发展为无需腹腔镜辅助的纯NOTES。当前的实验和临床研究聚焦于新的微创方法的实施以及这些手术操作的使用培训。近年来，柔性内镜NOTES和腔内手术在使用柔性内镜胆囊切除术、胆囊取石术和阑尾切除术的临床前和实验环境中越来越多地报告了良好结果。此外，柔性内镜淋巴结清扫术和甲状腺切除术是为内镜医师开辟新探索领域的新干预措施之一。
柔性内镜为内镜医师和外科医生开辟了新的领域。随着介入性内镜设备的增加以及内镜医师安全进行高级干预的能力的提升，这不可避免地推动了将新技术与创新思维相结合的向前发展。
