9Natural Orifice Translumenal Thoracoscopic Surgery: Does the Slow Progress and the Associated Risks Affect Feasibility and Potential Clinical Applications?

all conventional teaching; however, since the first human natural orifice translumenal endoscopic sur-gery (NOTES) operation in April 2007,1 the tech-nique has gained extensive interest worldwide. The original concept of the approach was modeled around abdominal surgery. The technique is described as using a flexible, dual lumen gastroscope passed to the stomach in the same way as for a diagnostic gas-troscopy. A gastrotomy allows the endoscope access to the peritoneal cavity and the target operative site. The required surgical procedure can then be undertaken using instruments passed down the biopsy channels of the endoscope.2 This has become the basis for the exploration of the technique, with numerous animal Using the body’s natural orifices to gain access to the thoracic or abdominal cavity explores a surgical technique that struggles agains