Natural orifice surgery (NOS)—Toward a single-port transdouglas approach for intra-abdominal procedures

ObjectiveTo describe a future method for abdominal surgical procedures in women using a single-port Transdouglas Endoscopic Device (TED).Methods and descriptionThe first successful laparotomy was performed in the 19th century, and the first endoscopic operation in the 20th century. The 21st century started with experimental operations using the natural body openings. Various abdominal procedures have already been performed through the stomach, but it seems that the transdouglas pathway in women is the most promising access into the peritoneal cavity, for its safety and cost-effectiveness. The TED is designed to perform operations in the upper and the lower abdomen. The New European Surgical Academy (NESA) founded the first European based interdisciplinary working group in order to plan and design instruments toward future gynaecological, urological and surgical applications.ConclusionThe single-port TED is expected to replace many of today's endoscopic procedures due to its probably higher safety and better ergonomics.