New technology and applied research: What the future holds for LESS and NOTES

Rapid technological developments in the 1970's contributed to the emergence of operative laparoscopy as a revolution in surgery. In recent years, there has been a surge of interest in laparoendoscopic single-site (LESS) and natural orifice translumenal endoscopic surgery (NOTES), novel techniques that have the potential to further minimize the invasiveness and morbidity of surgery. Innovations in instrument design and in novel surgical platforms including robotic technology have rapidly been developed in an effort to enhance the future clinical applicability of these techniques. In this chapter, we review the current status and future directions of LESS and NOTES technology, focusing on the current research in the field.