NOTES

NOTES (Natural Orifice Transluminal Endoscopic Surgery) is an emerging surgical approach which aims to utilize the body’s natural openings, such as the mouth, rectum or vagina as a conduit for an operation. According to the NOSCAR (Natural Orifice Surgery Consortium for Assessment and Research) consortium, the idea of NOTES was developed several years ago in response to the concepts that patients would 1) realize the benefits of less invasive surgery by reducing the recovery time, 2) experience less physical discomfort associated with traditional procedures and, 3) have virtually no visible scarring following this type of surgery.

RealHand HD instruments are playing a key part in NOTES surgery and have been employed in a number of transvaginal NOTES cholecystectomies. In September 2007, Novare announced the successful completion of the first NOTES gallbladder removal procedures performed using RealHand HD instruments. Santiago Horgan, M.D., professor of surgery and director of minimally invasive surgery, and Mark A. Talamini, M.D., professor and chair of the Department of Surgery at UC San Diego Medical Center performed California’s first NOTES surgery on a 42-year old San Diego resident. Her gallbladder was removed through the vagina during a 1.5 hour procedure. Dr. Horgan’s transvaginal NOTES procedures were the first such cases that only two surgical ports were necessary: one in the belly button and another through the vagina, thereby hiding any visible scaring.

RealHand NOTES instruments are custom designed to accommodate the requirements of the transvaginal NOTES procedures. Novare will continue to develop instrumentation to support this and other NOTES approaches and is supporting the ongoing development of this exciting new surgical therapy.