[What does NOTES yield?].
BACKGROUND
The aim of this review is to inform about the possibilities offered by NOTES (Natural Orifice Transluminal Endoscopic Surgery). This technique allows to access into the peritoneal cavity, respectively thoracic cavity, through natural orifices using endoscopical visualization. This technique unites the skills of surgeons and endoscopists.


METHODS
The laparotomy or laparoscopy (in parallel into the thoracic cavity) was required for the access into the peritoneal cavity (thoracic cavity) historically. NOTES uses the following accesses: transgastric, PEG-like access, transcolical, transvesical, transvaginal with or without possible mini-laparoscopical control. Since the introduction of this method for the first time in 2004, many studies have been published. Using the databases Medline the authors searched the current view on NOTES technique. They focused on current possibilities offered by this technique. They searched advantages of this technique and its weak points as well. They looked at recommendations leading to the application of this technique for human.


RESULTS
More than 100 articles focusing on this subject were published together according to Medline. The single articles present animal studies, technical problems, and suggestions for technical equipment improvement and review articles. They are verbal presentation about successful transgastric or transvaginal appendicectomy or cholecystectomy by humans.


CONCLUSIONS
They are many controversies obstructing introduction of this method into common praxis. This technique is undergoing an immense progression and it is not possible to only passively observe this dynamic development, but it is necessary to actively make the indications and contraindications for the possible usage of this method.
Zonca
P
P
Chirurgické a traumatologické oddelení, MN Ostrava. pavel.zonca@hotmail.co.uk
Neoral
C
C
Malý
T
T
Hájek
M
M
Lerch
M
M
D004724:Endoscopy / Q000379:methods; D006801:Humans