We are independent & ad-supported. We may earn a commission for purchases made through our links.
Advertiser Disclosure
Our website is an independent, advertising-supported platform. We provide our content free of charge to our readers, and to keep it that way, we rely on revenue generated through advertisements and affiliate partnerships. This means that when you click on certain links on our site and make a purchase, we may earn a commission. Learn more.
How We Make Money
We sustain our operations through affiliate commissions and advertising. If you click on an affiliate link and make a purchase, we may receive a commission from the merchant at no additional cost to you. We also display advertisements on our website, which help generate revenue to support our work and keep our content free for readers. Our editorial team operates independently of our advertising and affiliate partnerships to ensure that our content remains unbiased and focused on providing you with the best information and recommendations based on thorough research and honest evaluations. To remain transparent, we’ve provided a list of our current affiliate partners here.

What is Natural Orifice Surgery?

Tricia Christensen
Updated Mar 03, 2024
Our promise to you
The Health Board is dedicated to creating trustworthy, high-quality content that always prioritizes transparency, integrity, and inclusivity above all else. Our ensure that our content creation and review process includes rigorous fact-checking, evidence-based, and continual updates to ensure accuracy and reliability.

Our Promise to you

Founded in 2002, our company has been a trusted resource for readers seeking informative and engaging content. Our dedication to quality remains unwavering—and will never change. We follow a strict editorial policy, ensuring that our content is authored by highly qualified professionals and edited by subject matter experts. This guarantees that everything we publish is objective, accurate, and trustworthy.

Over the years, we've refined our approach to cover a wide range of topics, providing readers with reliable and practical advice to enhance their knowledge and skills. That's why millions of readers turn to us each year. Join us in celebrating the joy of learning, guided by standards you can trust.

Editorial Standards

At The Health Board, we are committed to creating content that you can trust. Our editorial process is designed to ensure that every piece of content we publish is accurate, reliable, and informative.

Our team of experienced writers and editors follows a strict set of guidelines to ensure the highest quality content. We conduct thorough research, fact-check all information, and rely on credible sources to back up our claims. Our content is reviewed by subject-matter experts to ensure accuracy and clarity.

We believe in transparency and maintain editorial independence from our advertisers. Our team does not receive direct compensation from advertisers, allowing us to create unbiased content that prioritizes your interests.

Natural orifice surgery, also known by the trademarked name of Natural Orifice Transluminal Endoscopic Surgery or NOTES, is sometimes called scarless surgery. Instead of making incisions on the outside of the body, access to an organ or tumor in the gastric or intestinal system can be gained by making an incision through one of the body’s natural orifices (mouth, vagina or colon). Natural orifice surgery is still in experimental stages, but there are patients who have had gallbladders removed via their mouth.

In some surgeries, it makes sense to perform surgery via access from a natural orifice. For instance, tonsillectomies are routinely performed through the mouth. Access to polyps in the colon is through a natural orifice. These have long been considered standard, and they are “scarless” procedures. In fact, the New European Surgical Academy founded NOS, to study all natural orifice surgery, those that have been traditionally performed and these new and experimental versions. NOTES is different, since it means mostly the new versions that were not already being performed through natural orifices, and also specializes in surgeries that would traditionally be performed by gastrointestinal surgeons.

Some patients may be better candidates for natural orifice surgery than others. Proponents of the technique say it could be particularly useful in obese patients because incisions on the outside tend to need to be larger to compensate for the presence of extra or larger fat cells. Removal of organs could also be complicated in people who have had net placed to fix hernias, since some of the net may be cut with incisions, and this could result in needing more hernia repairs in the future. Moreover, proponents of this method believe that not cutting through stomach muscle will speed recovery time for most patients, since pain from these surgeries is largely related to incisions.

Others argue that improvement in laparoscopic techniques makes many forms of natural orifice surgery mostly redundant, and more risky than the tiny incisions required for many laparoscopic procedures. The medical community is divided on this issue, and surgeries of this type have mostly been conducted in Europe and South America, though in 2008, a woman underwent a successful transvaginal appendectomy. The benefit of not cutting through the stomach muscles to access the appendix was appreciated by the patient, who said her soreness after the procedure was minimal.

Though this may change, there are still few experts on experimental natural orifice surgery, and because this is considered an experimental method, it’s a good idea to check with insurance if a surgeon proposes this type of surgery to you, since some insurance companies do not cover any treatments considered experimental. There are surgeons who aren’t completely supportive of natural orifice surgery, or who haven’t committed to an opinion as yet. Some experts would like more areas of this type of surgery defined, and specifically would like to see the issue of internal wound healing and risk of infection from this technique better understood. As more of these surgeries are performed, more data is likely to determine their degree of usefulness and the conditions under which such a surgery might be superior to other surgical methods.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Tricia Christensen
By Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia Christensen is based in Northern California and brings a wealth of knowledge and passion to her writing. Her wide-ranging interests include reading, writing, medicine, art, film, history, politics, ethics, and religion, all of which she incorporates into her informative articles. Tricia is currently working on her first novel.
Discussion Comments
By anon58994 — On Jan 05, 2010

Transvaginal endoscopic appendectomies was published in 2001 under the name of “Operative Culdolaparoscopy: A new Approach combining operative culdsocopy with minilaparoscopy” JAAGL. 2001; 8: 438-441

Tricia Christensen
Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia...
Learn more
The Health Board, in your inbox

Our latest articles, guides, and more, delivered daily.

The Health Board, in your inbox

Our latest articles, guides, and more, delivered daily.