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 robotic solutions.
The report also examines the future directions that minimally invasive surgery may take and the implications of this for medical device manufacturers.