Surgery involves the manipulation, repair or resection of tissue.  Two decades ago, we saw progression in surgical technique from traditional ‘open’ surgery to laparoscopic surgery.  With improvements in technology and the development of new techniques, endolumenal and translumenal therapies have the potential to treat many common gastrointestinal conditions as effectively as more traditional invasive procedures.  This significant paradigm shift will result in benefits to our patients and their employers, and improve access to surgical care l. SAGES fully endorses the evolution of new treatments for gastrointestinal conditions that provide patients a faster recovery from their procedures while at the same time providing high quality outcomes.  This document addresses the rationale for endolumenal therapies, considers the provider qualifications needed to perform these procedures, and discusses the issues of reimbursement and future directions. Read more..»

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Although the Natural Orifice Translumenal Endoscopic Surgery approach may hold tremendous potential, there are many issues that need to be addressed before this technique is introduced into clinical care, not the least of which is the issue of building skill sets required to perform these procedures. It is anticipated that the skill sets needed will be a hybrid that includes laparoscopic skills as well as advanced flexible endoscopic skills.

It is exciting to contemplate the potential for NOTES® in improving patient care and to know that ASGE and SAGES have taken the lead to ensure that it is developed in a safe and responsible manner. This White Paper represents a cooperative effort to accomplish that end.

The February 2006 White Paper was the main discussion tool used for the International Conference on Natural Orifice Translumenal Endoscopic Surgery (NOTES) which was held March 9-11, 2006 in Scottsdale, Arizona. 

The May 2006 White Paper states the outcomes of the NOTES® Conference and lays plans for future NOTES/NOSCAR activities.

Other resources are drawn from ASGE or SAGES publications and will be supplemented as additional materials become available.

NOTES White Paper, February 2006 (PDF)

White paper originally published in:
Gastrointestinal Endoscopy, Volume 63, No. 2: 2006
Surgical Endoscopy (2006) 20: 329-333