title: International multicenter trial on clinical natural orifice surgery--NOTES IMTN study: preliminary results of 362 patients.
abstract: OBJECTIVE
  Natural orifice translumenal endoscopic surgery (NOTES) is evolving as a promising alternative for abdominal surgery. IMTN Registry was designed to prospectively document early results of natural orifice surgery among a large group of clinical cases.
  
  
  METHODS
  Sixteen centers from 9 countries were approved to participate in the study, based on study protocol requirements and local institutional review board approval. Transgastric and transvaginal endoscopic natural orifice surgery was clinically applied in 362 patients. Intraoperative and postoperative parameters were prospectively documented.
  
  
  RESULTS
  Mean operative time for transvaginal cholecystectomy was 96 minutes, compared with 111 minute for transgastric cholecystectomy. A general complication rate of 8.84% was recorded (grade I-II representing 5.8%, grade III-IV representing 3.04%). No requirement for any analgesia was found in one fourth of cholecystectomy and appendectomy patients.
  
  
  CONCLUSIONS
  Results of clinical applications of NOTES in the IMTN Study showed the feasibility of different methods of this new minimally invasive alternative for laparoscopic and open surgery.
authors.affiliation: Department of Surgery, University Hospital Teresopolis HCTCO-FESO, Rio de Janeiro, Brazil. rzorron@terra.com.br
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authors.lastname: Zorron
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authors.lastname: Palanivelu
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authors.lastname: Galvão Neto
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authors.lastname: Ramos
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authors.lastname: Salinas
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authors.lastname: Corcione
authors.forename: Fausto
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authors.lastname: D'Avila Avila
authors.forename: Néstor
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authors.lastname: Arturo Gómez
authors.forename: Paulo Ayrosa
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authors.lastname: Galvão Ribeiro
authors.forename: Susana
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authors.lastname: Martins
authors.forename: Marcos
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authors.lastname: Filgueiras
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authors.lastname: Gellert
authors.forename: Anibal
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authors.lastname: Wood Branco
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authors.lastname: Kondo
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authors.lastname: Inacio Sanseverino
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authors.lastname: de Sousa
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authors.lastname: Saavedra
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authors.lastname: Sivakumar
authors.forename: Pidigu Seshiyer
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authors.lastname: Rajan
authors.forename: Priyadarshan Anand
authors.initials: PA
authors.lastname: Jategaonkar
authors.forename: Muthukumaran
authors.initials: M
authors.lastname: Ranagrajan
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Parthasarathi
authors.forename: Palanisamy
authors.initials: P
authors.lastname: Senthilnathan
authors.forename: Mohan
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authors.lastname: Prasad
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authors.lastname: Cuccurullo
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mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D011446:Prospective Studies; D012042:Registries; D013270:Stomach / Q000601:surgery; D013997:Time Factors; D014621:Vagina / Q000601:surgery