NOTES: Where have we been and where are we going?

Excerpt

On July 10th, 2008, The Third International Symposium on Natural Orifice Surgery (NOTES) will be held in San Francisco, California. It is worth noting that this meeting will occur almost 3 years to the day after a group of 12 investigators selected by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and the American Society for Gastrointestinal Endoscopy (ASGE) convened in New York City to discuss the feasibility of NOTES and create a plan for its systematic evaluation. A great deal has been accomplished since this group published The ASGE/SAGES White Paper on NOTES [1, 2]. While several highly critical editorials by senior surgeons have decried the futility of pursuing NOTES [3, 4], it is clear that NOTES remains one of the hottest topics in both the gastroenterology and gastrointestinal surgery communities and interest is evolving in the urologic and gynecologic surgery communities as well. The number of NOTES-based abstracts submitted to both the SAGES and DDW annual meetings has increased significantly each year. There is now clinical data demonstrating that basic NOTES procedures in humans are feasible. We believe that at this point NOTES is ready to carefully move from the laboratory to human trials to identify where NOTES approaches might be beneficial and where they are not. …