Natural Orifice Transluminal Endoscopic Surgery: Uses, Advantages, Complications and Cost
Author(s): Saif Saleh Ali Alhamyani and Tamer M Abdelrahman*
Abstract
Time has witnessed a steady decline in invasive surgical procedures. Laparoscopic surgeries have gradually replaced traditional open surgeries due to lesser postoperative morbidity, shorter hospitalization, faster convalescence, and better cosmetic outcome. Taking a step further, laparoscopy and endoscopy have been brought together for an advanced surgical technique called Natural Orifice Transluminal Endoscopic Surgery (NOTES). In NOTES, no scar is caused on the skin surface. The abdomen is approached through a natural orifice–mouth, anus, urethra or vagina and peritoneal cavity is accessed by puncturing a visceral organ. In this article, we have reviewed current applications of NOTES by explaining about post-operative pain, post-operative recovery time, duration of hospital stays, associated complications and cost. A literature search on NOTES was carried out in different search engines like PubMed, etc. We had searched for research articles on natural orifice transluminal endoscopic surgery in the abdomen. Filters were applied as research articles from the past 5 years, full free text, and studies on human subjects only. Only those articles which provide us information on post-operative pain, postoperative recovery time, duration of hospital stay, associated complications and cost were selected. Trans anal route provides access for many colonic and rectal surgeries. TAMIS and TEM are two examples of local excision of rectal tumors. The transvaginal route also provides access to plenty of gastrointestinal and urologic surgeries. All NOTES procedures are advantageous compared to conventional laparoscopic surgeries. In most surgeries’ patient can be discharged after 1 to 3 days. NOTES have few complications like bleeding, a risk of perforation, sexual dysfunction, urinary incontinence but these are less frequent compared to conventional surgeries. NOTES is cost effective too. Key words: Natural orifice, Transluminal, Endoscopy, Notes, Transvagi