Natural orifice translumenal surgery: Flexible platform review

Table 1 NOTES prototype specifications

Prototype	Paradigm	Working Length (cm)	Channels/Size (mm)	Diameter (mm)	Visualization	Positioning mechanism	Specializations	Procedures performed
DCE (EGD/Colonoscope)	Endoscopic	103/168	Two: 3.7, 2.8/Two: 3.7, 3.2	12.6/13.7	Standard endoscopic	Standard scope shaft	Two small parallel channels	Animal and human NOTES (Hybrid procedures)
NOTES scope	Endoscopic	133	Two: 2.8, 2.8	14.3	Standard endoscopic	Two bending segments, one lockable	Dual bending segments, orthogonal lifting gates	Animal hybrid NOTES
IOP	Endoscopic/Flexible-laparoscopic	110	Four: 7, 6, 4, 4	18	N-scope	Built in shaft-stiffening system	2.5cm gasping forceps with tissue anchors	Human NOTES, endoluminal bariatrics, anti-reflux procedures
EndoSAMURAI	Flexible-laparoscopic	103	Three: 2.8, 2.8, 2.8	15.7	Endoscopic	Uses a stiffening overtube system	Bimanual control enables 5 degrees of freedom for 2 end effectors	Animal NOTES
DDES	Flexible-laparoscopic	55	Three: 7, 4.2, 4.2	16 × 22	N-scope	Articulating guide sheath	Bimanual control with 7 degrees of freedom for 2 end effectors	Bench top EMR, ESD and skills assessment models

NOTES: Natural orifice translumenal surgery; DCE: Dual channel endoscope; EGD: Esophagogastroduodenoscope; IOP: Incisionless operating platform; DDES: Direct drive endoscopic system.