• Algorithms
• Cholangiopancreatography, Endoscopic Retrograde/methods
• Cooperative Behavior
• Diagnosis, Differential
• Drainage/methods
• Endosonography/methods
• Gastrostomy/methods
• Humans
• Image Interpretation, Computer-Assisted/methods
• Interdisciplinary Communication
• Jejunostomy/methods
• Laparoscopy/methods
• Magnetic Resonance Imaging/methods
• Pancreatic Neoplasms/diagnosis
• Pancreatic Pseudocyst/diagnosis
• Pancreatic Pseudocyst/etiology
• Pancreatic Pseudocyst/surgery
• Recurrence
• Stents
• Ultrasonography/methods
• Ultrasonography, Interventional

Minimally invasive surgery started spreading worldwide in 1987, when the first laparoscopic cholecystectomy was performed. Meanwhile, improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions, even beyond the wall barrier. The first transgastric peritoneoscopy, in 2004, brought to light the concept of natural orifice transluminal endoscopic surgery (NOTES). The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation. The authors present a review of all developments concerning NOTES, including animal studies and human experience.

• Transesophageal
• Transgastric
• Transvesical
• Transvaginal
• Transcolonic
• Natural orifice transluminal endoscopic surgery
• Minimally invasive techniques

A number of methods are available for the drainage of pancreatic pseudocysts, including percutaneous, endoscopic and open approaches. The author reviewed the most rently reports, and and summarized the latest advances in the pancreatic pseudocysts.

• Crohn's disease
• Pseudocysts
• aneurysms
• cyst
• duodenopseudocystostomy
• fungal
• gastropseudocystostomy
• pancreas
• pancreatitis
• percutaneous

Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique that has received considerable interest in recent years. Although minimal access surgery has increasingly replaced traditional open abdominal surgical approaches for a wide spectrum of indications, in pancreatic diseases its widespread use is limited to few indications because of the challenging and demanding nature of major pancreatic operations. Nonetheless, there have been attempts in animal models as well as in the clinical setting to perform diagnostic and resectional NOTES for pancreatic diseases. Here, we review and comment upon the available data regarding currently analyzed and performed pancreatic NOTES procedures. Potential indications for NOTES include peritoneoscopy, cyst drainage, and necrosectomy, palliative procedures such as gastroenterostomy, as well as resections such as distal pancreatectomy or enucleation. These procedures have already been shown to be technically feasible in several studies in animal models and a few clinical trials. In conclusion, NOTES is a rapidly developing concept/technique that could potentially become an integral part of the armamentarium dealing with surgical approaches to pancreatic diseases.

• Natural orifice transluminal endoscopic surgery
• Pancreatic disease
• Chronic pancreatitis
• Pancreatic resection
• Pancreatic drainage