title: [Natural orifice transluminal endoscopic surgery in Germany: Data from the German NOTES registry].
abstract: BACKGROUND
  The German NOTES registry (GNR) was initiated by the German Society for General and Visceral Surgery (DGAV) as a treatment and outcome database for natural orifice transluminal endoscopic surgery (NOTES).
  
  
  OBJECTIVE
  The aim of this study was the descriptive analysis of all GNR data collected over a 5-year period since its start in 2008 with more than 3000 interventions.
  
  
  METHODS
  The GNR is an online database with voluntary participation available to all German-speaking clinics. Demographic data, therapy details, complications and data on the postoperative course of patients are recorded. All cases in the GNR between March 2008 and November 2013 were included in the analysis.
  
  
  RESULTS
  From a total of 3150 data sets 2992 (95 %) were valid and suited for the analysis. Hybrid transvaginal cholecystectomy was the most frequently used procedure (88.7 %), followed by hybrid transvaginal/transgastric appendectomy (6.1 %) and hybrid transvaginal/transrectal colon procedures (5.1 %). Intraoperative complications occurred in 1.6 %, postoperative complications in 3.7 % and conversions were reported in 1.5 %. Intraoperative bladder injuries and postoperative urinary tract infections were identified as method-specific complications of transvaginal procedures. Bowel injuries occurred as a rare (0.2 %) but potentially serious complication of transvaginal operations.
  
  
  CONCLUSIONS
  The German surgical community ensures a safe and responsible introduction of the new NOTES operation techniques with its active participation in the GNR. Despite an overall low complication rate, the high number of procedures in the GNR permitted the identification of method-specific complications. This knowledge can be used to further increase the safety of NOTES in practice.
authors.affiliation: Chirurgische Klinik I, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Freie- und Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland, kai.lehmann@charite.de.
authors.forename: K S
authors.initials: KS
authors.lastname: Lehmann
authors.forename: C
authors.initials: C
authors.lastname: Zornig
authors.forename: G
authors.initials: G
authors.lastname: Arlt
authors.forename: M
authors.initials: M
authors.lastname: Butters
authors.forename: D R
authors.initials: DR
authors.lastname: Bulian
authors.forename: R
authors.initials: R
authors.lastname: Manger
authors.forename: J
authors.initials: J
authors.lastname: Burghardt
authors.forename: N
authors.initials: N
authors.lastname: Runkel
authors.forename: A
authors.initials: A
authors.lastname: Pürschel
authors.forename: J
authors.initials: J
authors.lastname: Köninger
authors.forename: H J
authors.initials: HJ
authors.lastname: Buhr
mesh_terms: D001062:Appendectomy / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D002763:Cholecystectomy / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D003082:Colectomy / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005858:Germany; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000628:therapy; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D012042:Registries; D014600:Utilization Review / Q000706:statistics & numerical data