scholarly journals Robotics for Natural Orifice Transluminal Endoscopic Surgery: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Xiaona Wang ◽  
Max Q.-H. Meng
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Endoscopic Surgery ◽  
Surgical Procedure ◽  
State Of The Art ◽  
Abdominal Cavity ◽  
Natural Orifice ◽  
Robotic Platforms ◽  
Flexible Instruments ◽  
Natural Orifices

Natural Orifice Transluminal Endoscopic Surgery (NOTES) involves accessing the abdominal cavity via one of the bodies’ natural orifices, for example, mouth, anus, or vagina. This new surgical procedure is very appealing from patients’ perspectives because it eliminates completely abdominal wall aggression and promises to reduce postoperative pain, in addition to all other advantages brought by laparoscopic surgery. However, the constraints imposed by both the mode of access and the limited technology currently available make NOTES very challenging for the surgeons. Redesign of the instruments is imperative in order to make this emerging operative access safe and reproducible. In this paper, we survey on the state-of-the-art devices used in NOTES and introduce both the flexible instruments based on improvement of current endoscopic platforms and the revolutionary concept of robotic platforms based on the convergence of communication and micromechatronics technologies. The advantages and limitations of each category are addressed. Potential solutions are proposed to improve the existing designs and develop robust and stable robotic platforms for NOTES.

Anesthetic Implications of Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Single-Incision Laparoscopic Surgery (SILS)

2011 ◽  
pp. 175-178
Author(s):  
Kai Matthes
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
Abdominal Cavity ◽  
Academic Research ◽  
Surgical Techniques ◽  
Single Incision Laparoscopic Surgery ◽  
Natural Orifice ◽  
Less Invasive ◽  
Novel Technique ◽  
Laparoscopic Techniques

Chapter 18 discusses natural orifice translumenal endoscopic surgery (NOTES), which is currently investigated as an experimental alternative to diagnose and treat abdominal pathology combining endoscopic and laparoscopic techniques. Using a translumenal approach, the abdominal cavity is accessed with flexible endoscopes through an incision in the stomach, colon, or vagina. By obviating abdominal incisions, this approach may be less invasive than standard surgical techniques. This novel technique is currently performed at a few academic research institutions, but these less invasive operations potentially can be performed in an office-based setting in the future.

scholarly journals Transvaginal Laparoscopically-Assisted Endoscopic Appendectomy: A Major Hybrid Natural Orifice Transluminal Endoscopic Surgery Case Series in Asia

2016 ◽  
Vol 101 (3-4) ◽  
pp. 153-160 ◽  
Author(s):  
Abdul Qadir Khan ◽  
Enyu Liu ◽  
Weibo Niu ◽  
Peng Li ◽  
Hazrat Gul ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Laparoscopic Appendectomy ◽  
Endoscopic Surgery ◽  
Surgical Procedure ◽  
Hybrid Approach ◽  
Case Series ◽  
Hybrid Technique ◽  
Natural Orifice ◽  
Conventional Laparoscopic ◽  
Hybrid Notes

This paper represents an evaluation of a hybrid approach to natural orifice transluminal endoscopic surgery (NOTES) and its performance relative to conventional procedures. Globally, numerous institutions have successfully implemented minimally invasive surgeries by applying NOTES techniques and achieved decreased morbidity while performing incision-less surgery. However, these techniques are still not common in surgical practice in China and Pakistan. Documenting the experiences and challenges encountered in implementing NOTES in such environments can provide guidance for NOTES implementation elsewhere. From May 2010 to April 2012, 16 human transvaginal appendectomies were carried out applying a hybrid NOTES technique using a solo-umbilical trocar, which provided a safe access for laparoscopic assistance during surgical procedure. After removal of the appendix transvaginally, the colpotomy was sutured under direct vision with absorbable stitches. The outcomes of cases treated with hybrid NOTES techniques were compared to those of conventional laparoscopic appendectomy. All patients underwent a successful surgical procedure with no intra- or postoperative complications and provided no specific complaints during the 10th day and a monthly follow-up for 2 years. The patients convalesced promptly with healthy and satisfactory cosmetic results. Compared to conventional laparoscopic appendectomy, the hybrid NOTES operation had less postoperative pain, lower cost, and shorter hospitalization. Hybrid NOTES procedures can be performed safely using a solo-umbilical trocar. Our initial experience reveals that this hybrid technique is practically feasible and associated with minimal postoperative pain, reasonable convalescence time, and improved cosmetic outcomes.

scholarly journals Modular Assembly Micro-Robots for Natural Orifice Transluminal Endoscopic Surgery

Robotics ◽  
2013 ◽  
pp. 1600-1612
Author(s):  
Apollon Zygomalas ◽  
Kostas Giokas ◽  
Dimitris Koutsouris
Keyword(s):  
Surgical Technique ◽  
Endoscopic Surgery ◽  
Abdominal Cavity ◽  
Minimally Invasive Techniques ◽  
Natural Orifice ◽  
Modular Assembly ◽  
Invasive Techniques ◽  
Miniature Robot ◽  
Surgical Operations ◽  
Natural Orifices

Surgical operations are progressively being performed using minimally invasive techniques. Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a novel surgical technique that uses the natural orifices of the human body in order to approach the peritoneal cavity. There are two basic types of robotics for NOTES; the external robots that stay outside the patient but act inside the abdominal cavity, and the internal robots that stay and act in the abdomen. The internal robots could only be mini-robots. The development of modular assembling reconfigurable micro-robots is a revolutionary idea for the NOTES. Modular micro-robots consist of small subunits which could be assembled and construct a functional miniature robot. These surgical micro-robots may increase the possibility for true scarless tele-surgery. Although specific applications of intrabdominal surgical micro-robots are still in an early concept stage, the field is rapidly evolving. In the future, patients may be operated by specialized micro-robotic intrabdominal surgeons.

ROBOTICS IN NATURAL ORIFICE TRANSLUMINAL ENDOSCOPIC SURGERY

2013 ◽  
Vol 13 (02) ◽  
pp. 1350044 ◽  
Author(s):  
YUE ZHOU ◽  
HONGLIANG REN ◽  
MAX Q.-H. MENG ◽  
ZION TSZ HO TSE ◽  
HAOYONG YU
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
System Development ◽  
Abdominal Cavity ◽  
Recovery Period ◽  
Skin Incision ◽  
Surgical Instruments ◽  
Natural Orifice ◽  
The Arts ◽  
Post Operative Pain

Natural orifice translumenal endoscopic surgery (NOTES) is the latest surgery paradigm in which the abdominal cavity is accessed via the body's natural orifice, e.g., vagina, mouth, etc. Compared with traditional laparoscopic surgery, NOTES completely eliminates the skin incision and therefore benefits the patients in several aspects such as less post-operative pain, shorter recovery period, fewer complications, etc. Due to the unique characteristics of NOTES, instruments for traditional laparoscopic surgery are not suitable for NOTES and hence novel hardware design is necessary for facilitating system development. This paper gives an overview of the state of the arts in the development of surgical instruments for NOTES, particularly with a focus on the promising robotic endoscopes.

Anesthetic Implications of Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Single-Incision Laparoscopic Surgery (SILS)

2018 ◽  
Author(s):  
Mark A. Gromski ◽  
Kai Matthes
Keyword(s):  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Endoscopic Surgery ◽  
Single Incision ◽  
Single Incision Laparoscopic Surgery ◽  
Natural Orifice ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Current State ◽  
Field Notes

This chapter introduces the concepts of natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS). The field of NOTES has evolved over the past decade, and this developmental framework is also outlined to help better understand the current state of the field. NOTES describes a minimally invasive approach to surgical diseases in which instruments are passed transluminally to achieve access to the desired body. SILS is a minimally invasive approach carried out as an extension of traditional laparoscopic surgery. The anesthetic implications of NOTES and SILS are explained, including potential complications that are unique to each. Finally, future directions in developmental endoscopy are discussed to give a sense of what types of procedures may become available or commonplace in the coming decade.

scholarly journals The use of single incision laparoscopic surgery techniques and natural orifice transluminal endoscopic surgery – a nationwide survey

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
R Fahrner ◽  
F Mazzola ◽  
M Adamina
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
Single Incision ◽  
Nationwide Survey ◽  
Small Bowel Resection ◽  
Public Hospitals ◽  
Visceral Surgery ◽  
Single Incision Laparoscopic Surgery ◽  
Natural Orifice ◽  
The Past

Abstract Objective Since the first report of transgastric peritoneoscopic surgery in 2004, minimal invasive surgery (MIS) including conventional laparoscopy, natural orifice transluminal endoscopic surgery (NOTES), single incision laparoscopic surgery (SILS), and robotic surgery have gained traction in general and visceral surgery. While laparoscopic surgery is now the gold standard in many institutions, other MIS approaches lag behind in spite of the enthusiasm of few promoters. The present study investigates the current role of NOTES and SILS in Switzerland. Methods All Swiss surgical departments where queried. Heads of department were asked to complete a detailed questionnaire regarding the use of NOTES and SILS techniques, reminders were sent twice. Results Of 93 departments queried, 63 (68%) answered the survey and most were public hospitals (92%). One third of general surgery departments and 46% of visceral surgery departments had the highest accreditation level A and V1, respectively. While up to 27% of the responding hospitals had performed NOTES in the past, only about 9% still use the technique today. Since January 2019, only two departments performed NOTES cholecystectomy, one department NOTES colectomy and three departments NOTES total mesorectal excision. The main reasons for not performing NOTES anymore were lack of perceived benefits, higher costs, increased morbidity in routine procedures, no patient demand, and the lack of surgical expertise. A similar picture was found regarding the use of SILS, with 37% of hospitals having past experience with SILS and only 13% still performing SILS procedures. Yet, significantly more institutions performed a broader range of SILS procedures today: SILS appendectomy (n = 2), SILS cholecystectomy (n = 4), SILS thyroidectomy (n = 1), SILS small bowel resection (n = 2), SILS colonic resection (n = 5), and SILS rectal resection (n = 2). The main reasons for not performing routinely SILS were similar to the rationale against NOTES. Conclusion Due to technical limitations and lack of perceptible benefits, NOTES and SILS are less frequently performed nowadays than they were in the past. Only a minority of departments are still performing NOTES and SILS, including cholecystectomies, appendectomies, thyroidectomies, and bowel resections. Whether the rise in use of robotic techniques correlates with the decrease of NOTES and SILS needs further investigation.

Meta-analysis of hybrid natural-orifice transluminal endoscopic surgery versus laparoscopic surgery

2017 ◽  
Vol 104 (8) ◽  
pp. 977-989 ◽  
Author(s):  
D. C. Steinemann ◽  
P. C. Müller ◽  
P. Probst ◽  
A.-C. Schwarz ◽  
M. W. Büchler ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
Meta Analysis ◽  
Natural Orifice
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