Abstract
This review aims to summarise clinical applications of natural orifice translumenal endoscopic surgery (NOTES) in bariatric surgery. A review of data, until December 2014, was carried out regarding techniques and outcomes of bariatric NOTES procedures. Nine publications were included in the final analysis, with another six papers describing endolumenal procedures included for comparison. All NOTES studies adopted a hybrid procedure. Hybrid NOTES sleeve gastrectomy (hNSG) was described in four humans and two porcine studies. In humans, six subjects (23.1 %) were converted to conventional laparoscopic methods, and one postoperative complication (3.8 %) was reported. Mean excess weight loss was 46.6 % (range 35.2–58.9). Transvaginal-assisted sleeve gastrectomy appears feasible and safe when performed by appropriately trained professionals. However, improvements must be made to overcome current technical limitations.
Highlights
Bariatric surgery aims to reduce comorbidities and limit long-term health implications in obese patients including diabetes mellitus, hypertension, hyperlipidaemia and obstructive sleep apnoea
This study aims to review currently published literature in relation to bariatric natural orifice translumenal endoscopic surgery (NOTES) applications in terms of clinical outcomes, as well as variations in surgical techniques and to OBES SURG (2016) 26:422–428 provide guidance on current practices as well as future areas for research
All studies favoured the use of a hybrid approach over a pure NOTES procedure
Summary
Bariatric surgery aims to reduce comorbidities and limit long-term health implications in obese patients including diabetes mellitus, hypertension, hyperlipidaemia and obstructive sleep apnoea. There is a significant body of evidence supporting the benefits of bariatric surgery in regard to both weight loss and reduction of comorbidities [1,2,3]. There is evidence from other interventions to support further minimisation beyond conventional laparoscopic techniques using single-incision laparoscopic surgery (SILS). Evidence regarding SILS cholecystectomy morbidity is favourable [4], and there is some indication the SILS approach provides improved cosmesis compared to current laparoscopic practice [5]. Data regarding SILS bariatric procedures is scarce. There is data to support the use of SILS over multiple ports in a select group of patients [6]
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