Seit der ersten Publikation zu NOTES (natural orifice transluminal endoscopic surgery) im Jahr 2004 wächst das Interesse an dieser neuen minimal invasiven Operationsmethode stetig. NOTES stellt eine neue und möglicherweise weniger invasive Alternative zur laparoskopischen Operationstechnik dar. Während der transluminale Zugang in die Peritonealhöhle leicht möglich ist, bestehen derzeit noch viele technische Herausforderungen, die vor einem klinischen Einsatz von NOTES gelöst werden müssen. Aktuelle Probleme sind die Entwicklung von nahezu 100% verlässlichen Verschlussmechanismen, Strategien zur Vermeidung intraperitonealer Infektionen, stabile Geräteplattformen, die eine zuverlässige Organretraktion und dissektion erlauben, und die Evaluation sinnvoller klinischer Indikationen. Während fast alle diese Probleme zurzeit noch ungelöst sind, sind als erste «Nebenprodukte» der NOTES-Forschung bereits Operationen über einzelne para- oder transumbilikale Trokare und verlässliche neue Verschlussmethoden für gastrointestinale Perforationen für den klinischen Alltag verfügbar.

Keywords:
NOTES, Natural orifice transluminal endoscopic surgery, Endoskopie, Narbenlose Chirurgie
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© 2009 S. Karger AG, Basel
2009
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