NOTES: What Is the Current Status and Will It Ever See the Light of Day?

Natural orifice translumenal endoscopic surgery (NOTES) is an emerging field within gastroenterology and gastrointestinal surgery, in which the surgeon accesses the peritoneal cavity through a hollow viscus and performs a diagnostic or therapeutic intervention. Introduction of this new field of endolumenal surgery has proceeded in a slow and careful manner. The most common NOTES procedure currently performed worldwide is a transvaginal cholecystectomy. Because of the concerns over bacterial contamination, transanal and transcolonic NOTES procedures are rarely performed. Current research in transanal NOTES procedures are coming to fruition, with hybrid NOTES colorectal resections now in early clinical investigations.