Innovative Intersection of Endoscopy and Laparoscopy or Deadend?

What is NOTES?  Natural orifice translumenal endoscopic surgery (NOTES) is vying to be the ‘next big thing’ in minimally invasive surgery (MIS), but to date, few clinical applications have surfaced beyond a few isolated reports.  NOSCAR, a national collaborative research consortium between surgeons and gastroenterologists, vendor funded, has directed $2.25 million for basic research related to NOTES in the last 12 months. While transdisciplinary collaboration is key to future breakthroughs in healthcare, are we asking the right questions?  Is removal of the gallbladder through the vagina the best focus for this emerging area?  Cutting edge GI interventionalists are using a 50 year old endoscope, unimpeded by progress, and 20 year old laparoscopic instruments akin to ‘chop stick’s observing two-dimensional imaging of their patients’ three-dimensional operations.  We can do better. What do we need?

See-M.  Marohn’s-Presentation-Natural Orifice Translumenal Endoscopic Surgery (NOTES)