Natural Orifice Transluminal Endoscopic Surgery and Transrectal Abscess Drainage: Is this what We Are Getting Into?

Hotel Dieu Hospital, Division of Gastroenterology, Department of Medicine, Queen’s University, Kingston, Ontario Correspondence: Dr Lawrence C Hookey, 166 Brock Street, Hotel Dieu Hospital, Kingston, Ontario K7L 5G2. Telephone 613-544-3310, fax 613-544-3114, e-mail hookeyl@hdh.kari.net Received and accepted for publication July 10, 2008 N orifice transluminal endoscopic surgery (NOTES) has advanced dramatically over the past year. Research teams are starting to publish results more frequently (90 articles to date in 2008, 73 in 2007, and 15 in 2006). The scientific method is now being applied to ideas in an effort to refine any technique in animal models before embarking on its use in humans. That being said, there are several ongoing trials of hybrid NOTES/laparoscopic surgeries in human subjects. There continues to be major interest from members of the medical device industry with further research funding available through NOTES-specific associations and prototype development well underway by these key players in endotherapy. However, there are some key issues yet to be addressed with satisfaction, including: