Will "NOTES" Revolutionize Surgery?

Article preview from Medtech Insight - July 2008

NOTES is an experimental alternative to conventional surgery that uses a combination of endoscopic and laparoscopic techniques to access the peritoneal cavity through the wall of the alimentary canal or other natural orifices, allowing surgeons and gastroenterologists to perform complex surgery without leaving any visible scars. In the last few years, NOTES research, procedures, patents, and venture capital investment have increased exponentially. And although the field is still unproven, the rush to NOTES is being fueled by several important motivators, including the perceived advantages over conventional surgery, patient demand, and a worldwide market potential believed to range between $2 and $4 billion per year.

NOTES: Revolutionizing Surgery

by Anne Staylor

Life is said to imitate art, and in the case of surgical advances, one need look no further for an example of this phenomenon than the innovations currently underway in the field of Natural Orifice Translumenal Endoscopic Surgery (NOTES). Numerous movies and television shows have glimpsed a future when all sorts of complex medical procedures, including surgery, are performed with nary a stethoscope (and certainly not a scalpel) in sight. For example, fans of the original Star Trek series remember Dr. Leonard "Bones" McCoy, the resident starship physician who was able to perform a wide range of complicated procedures on patients while leaving no scars whatsoever. Although such a utopian vision of the future still exists only in the realm of science fiction, the concept of incisionless, scarless surgery is no longer a mere fantasy, thanks to the rapidly advancing field of NOTES. In fact, step into the lecture halls of some recent medical meetings and you'll find that NOTES has grown more quickly in the last two years than anyone could have ever imagined.

NOTES is an experimental alternative to conventional surgery that uses a combination of endoscopic and laparoscopic techniques to access the peritoneal cavity through the wall of the alimentary canal or other natural orifices, allowing surgeons and gastroenterologists to perform complex surgery without leaving any visible scars. Between 2006 and 2008, NOTES research, procedures, patents, and venture capital investment have increased exponentially. And although the field is still unproven, the rush to NOTES is being fueled by several important motivators, including the perceived advantages over conventional surgery, patient demand, and a worldwide market potential believed to range between $2 and $4 billion per year, according to estimates from NeoGuide Systems Inc. and Apollo Endosurgery Inc., two companies active in this area.

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Companies mentioned in this article:

Apollo Endosurgery Inc.
Boston Scientific Corp.
Chinese University of Hong Kong
Columbia University
Columbia University Medical Center
Covidien Ltd.
Johns Hopkins University
Johnson & Johnson
Ethicon Endo-Surgery Inc.
Mayo Clinic College of Medicine
Minos Medical Inc.
Nebraska Surgical Solutions Inc.
NeoGuide Systems Inc.
Northwestern University
Novare Surgical Systems Inc.
Olympus Corp.
Olympus Medical Systems Corp.
Power Medical Interventions Inc.
USGI Medical
University of California
University of California, San Diego
University of Texas
University of Texas Medical Branch

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