Surgical innovation: From laparoscopy to natural orifice translumenal endoscopic surgery

The field of surgery has undergone a revolution in the past 25 years, progressing toward a less invasive approach to address surgical pathology. With the introduction of laparoscopy, operations classically associated with significant morbidities could now be accomplished on an almost outpatient basis. More recently, single-site laparoscopic surgery and natural orifice translumenal endoscopic surgery (NOTES) have been introduced for use in humans. These new techniques promise new approaches to minimize the potential morbidities and maximize the cosmetic outcome for patients. Herein is a discussion on surgical innovation detailing the progression from laparoscopic approaches to NOTES within the United States, including the limitations prohibiting the widespread adoption of these new techniques.