title: Surgeon perceptions of Natural Orifice Translumenal Endoscopic Surgery (NOTES).
abstract: BACKGROUND
  If proven feasible and safe, Natural Orifice Translumenal Endoscopic Surgery (NOTES) would still need acceptance by surgeons if it were to become a mainstream approach.
  
  
  METHODS
  Three hundred fifty-seven surgeons responded to a preliminary survey describing NOTES and were asked to rate the importance of various surgical considerations and (assuming availability and safety) if they would choose to undergo and/or perform cholecystectomies by NOTES or laparoscopy and why.
  
  
  RESULTS
  The risk of having a complication was considered most important. NOTES was theorized to be riskier and to require greater skill than laparoscopy but to potentially cause less pain and convalescence. Nearly three-fourths (72%) of surgeons expressed interest in NOTES training which correlated with younger age, SAGES membership, minimally invasive surgery specialization, and flexible endoscopic volume. Forty-four percent would like to introduce NOTES cholecystectomy into their practices. Among those not preferring NOTES, 88% would adopt NOTES if data showed improved outcomes over laparoscopy. Finally, only 24% would choose to undergo cholecystectomy themselves by NOTES, believing it to be too new and riskier than laparoscopy.
  
  
  CONCLUSIONS
  The risk of having a complication is the greatest concern among surgeons, and safety will affect NOTES acceptance.
  
  
  CONCLUSIONS
  The results of this survey seem to justify more focused future investigations.
authors.affiliation: Department of Surgery, Northwestern University Feinberg School of Medicine, Galter 3-150, 251 E. Huron St., Chicago, IL 60611, USA. e-volckmann@md.northwestern.edu
authors.forename: Eric T
authors.initials: ET
authors.lastname: Volckmann
authors.forename: Eric S
authors.initials: ES
authors.lastname: Hungness
authors.forename: Nathaniel J
authors.initials: NJ
authors.lastname: Soper
authors.forename: Lee L
authors.initials: LL
authors.lastname: Swanstrom
mesh_terms: D001291:Attitude of Health Personnel; D016145:Endoscopy, Digestive System / Q000379:methods / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D012007:Rectum; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014621:Vagina