Natural orifice translumenal endoscopic surgery: Current status and future technical development

Yongnam Song, Yoonjin Kim, Choongsoo S. Shin, Daehie Hong

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


The technology behind NOTES, an evolutionary endoscopic surgery conducted through the natural orifices of the patient to completely eliminate external post-operative scars, has been substantially improved in the last decade. The scarless nature of NOTES is believed to decrease the chance of wound infections and incision hernias, improve recovery times and increase the cosmetic satisfaction of patients. Although various animal and human studies have extended our understanding of physiology and the requirements of NOTES procedures, current NOTES technology is still too rudimentary to be applied to various clinical settings due to the technical and instrumental limitations. Recently, numerous efforts have been made in the development of proper surgical instruments for NOTES procedures. A secure closure method for luminal perforation is one of the most actively investigated areas, and several promising devices have already been introduced. A virtual navigation system for flexible endoscopic instruments would be beneficial for surgical reliability and safety issues by assisting the narrow endoscopic visual field. Various retraction devices are also necessary to enable complex endoscopic surgical maneuvers. Unfortunately, engineers have only taken supportive roles in the history of NOTES development, though engineering experience and knowledge are crucial for the development of complicated and miniaturized endoscopic devices. The active involvement of engineers in NOTES technology is required for the realization of NOTES in routine clinical practice.

Original languageEnglish
Pages (from-to)859-867
Number of pages9
JournalInternational Journal of Precision Engineering and Manufacturing
Issue number5
Publication statusPublished - 2013 May

Bibliographical note

Funding Information:
This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2011-0001150) and by the Human Resources Development program (No. 20124010203250) of the Korea Institute of Energy Technology Evaluation and Planning (KETEP) grant funded by the Korean Ministry of Knowledge Economy.


  • Endoscope
  • Laparoscope
  • Medical Devices
  • Natural Orifice Surgery
  • Surgery
  • Surgical Instruments

ASJC Scopus subject areas

  • Mechanical Engineering
  • Industrial and Manufacturing Engineering
  • Electrical and Electronic Engineering


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