In recent years there has been an increasing amount of interest and focus on
two new approaches in surgery, Single Port Access Surgery (SPA) and Natural
Transluminal Endoscopic Surgery (NOTES). Both NOTES and SPA also have the
advantage of an improvement in cosmesis It is also believed that NOTES could
offer all the benefits of laparoscopic surgery with the included advantage of
not requiring any abdominal wall incisions and therefore, eliminating the
possibility of wound infection and incisional hernias. Other proposed benefits
of SPA surgery are similar to those proposed for NOTES surgery, these being
reduced post operative pain, faster recovery, and a reduced need for
analgesia; at present evidence to support these suggested benefits is limited.
This reports examines the applications and challenges of both of these novel
approaches to surgery and investigates the technological barriers, and some
of the solutions that have been developed to overcome these barriers including
access ports, camera solutions, hand instruments, multi-tasking platforms and
The report also examines the future directions that minimally invasive surgery
may take and the implications of this for medical device manufacturers.