Editorial
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Aug 21, 2010; 16(31): 3859-3864
Published online Aug 21, 2010. doi: 10.3748/wjg.v16.i31.3859
Natural orifice transluminal endoscopic surgery in pancreatic diseases
Sonja Gillen, Jörg Kleeff, Michael Kranzfelder, Shailesh V Shrikhande, Helmut Friess, Hubertus Feussner
Sonja Gillen, Jörg Kleeff, Michael Kranzfelder, Helmut Friess, Hubertus Feussner, Department of Surgery, Technische Universität München, 81675 Munich, Germany
Shailesh V Shrikhande, Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Tata Memorial Hospital, Mumbai, 400 012, India
Author contributions: Gillen S, Friess H and Kleeff J designed and initiated the study; Gillen S, Kranzfelder M and Kleeff J performed a literature search; additional cross searching was performed by Shrikhande SV and Feussner H; Gillen S and Kleeff J drafted and wrote the manuscript; Kranzfelder M, Feussner H and Friess H critically revised the manuscript; all authors read and approved the final version of the manuscript and agree with the manuscript´s results and conclusions.
Correspondence to: Jörg Kleeff, MD, Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany. kleeff@chir.med.tu-muenchen.de
Telephone: +49-89-41405098 Fax: +49-89-41404870
Received: May 8, 2010
Revised: May 31, 2010
Accepted: June 7, 2010
Published online: August 21, 2010
Abstract

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.

Keywords: Natural orifice transluminal endoscopic surgery; Pancreatic disease; Chronic pancreatitis; Pancreatic resection; Pancreatic drainage