Letter to the Editor: Surgical Endoscopy

Excerpt

We read with interest the white paper entitled, “ASGE/SAGES Working Group on Natural Orifice Transluminal Endoscopic Surgery” authored by Ratner and colleagues [1] and applaud the efforts of the ASGE/SAGES working group to advance the principles and awareness of natural-orifice surgery among all subspecialties. In the white paper, the working group notes that “natural orifices may provide the entry point for surgical interventions in the peritoneal cavity.” [1] The white paper then cites Kalloo et al. as publishing the initial description of natural orifice surgery [2]. Clarification of this point is required. Kalloo et al. reported the first transgastric procedure, but the first published description of modern natural orifice surgery fulfilling the current definition of NOTES was a report on transvaginal nephrectomy by Gettman et al. in 2002 [3]. Using overtubes and the combination of flexible and rigid endoscopes, transvaginal nephrectomies were successfully performed in a survival porcine model. The work was not reported as NOTES simply because the concept and term had yet to be coined by the ASGE/SAGES working group. …