This document discusses the history and development of natural orifice translumenal endoscopic surgery (NOTES) and its applications in urology. It describes some of the early experimental NOTES procedures in urology starting in 2002. It also discusses the first reported human NOTES transvaginal nephrectomy performed in 2009. More recently, there has been a focus on reduced port and single incision laparoscopic techniques like laparo-endoscopic single site (LESS) surgery and transumbilical procedures which further decrease the invasiveness and improve cosmesis compared to standard laparoscopy. The document presents some key studies and reports on various NOTES and LESS procedures that have been performed in uro

1. NOTES / LESSem Urologia Experiência InicialDr. Anibal W. BrancoCEVIP - Curitiba - PRXI Curso Internacional de Cirurgias Urológicas por Vídeo

2. What is NOTESNatural OrificeOral, Anal, Vaginal, UrethralTrans-lumenalAcross the wall of a hollow viscusStomach, Colon/Rectum, Bladder, VaginaEndoscopicUse of an endoscopeRigid / FlexibleSurgeryCutting, Removing, Suturing tissues

3. NOTES1996 Apollo group: Tony Kalloo et alGroup of gastroenterologists exploring NOTES possibilities

4. Experimental Notes in Urology-Gettman MT, Lotan Y, Napper CA, Cadeddu JA. Transvaginal laparoscopic nephrectomy: development and feasibility in the porcine model. Urology 2002;59:446-50-Clayman RV, Box GN, Abraham JB, et al. Rapid communication:Transvaginal single-port NOTES nephrectomy: initial laboratory experience. J Endourol 2007;21:640–4.

5. Eur Urol 2008 Jan;53:1290–4

6. -Hybrid Transvaginal Nephrectomy EAU Meeting 2008 Milan Video Session 1 Branco AW et al-Hybrid Tranvaginal Nephrectomy European Video Journal May-Sep 2009 Branco AW et alH

9. Eur Urol. 2010 Jan;57(1):138-44. Epub 2009 Apr 22.NOTES hybrid transvaginal radical nephrectomy for tumor: stepwise progression toward a first successful clinical case. Sotelo R, Carmona O, Desai M, Gill IS Eur. Urol. 2010 Feb;57(2):233-7. Epub 2009 Sep 18.Feasibility of transvaginal NOTES-assisted laparoscopic nephrectomy. Alcaraz A, Molina A, Peri L, Ribal MJ 14 pctes. E.A.U. Meeting 2010 Barcelona Notes Assisted Live Donor Nephrectomy Alcaraz A et al .

11. Urology. 2009 Jul;74(1):5-8.NOTES transvaginal nephrectomy: first human experience. Kaouk JH, Crouzet RK, Moore C, Ingber MS, Haber GPEur Urol. 2009 Oct 28. [Epub ahead of print]Pure Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Nephrectomy.Kaouk JH, Crouzet RK, Moore C, Ingber MS, Haber GP420 min.

12. LESS -Single-port -Single-incison -Trans-Umbilical -NOTUS

13. (Single-Port)

14. Instrumentos Flexíveis

15. ProcedimentosNefrectomias(Simples, Radical, Doador, Nefroureterectomia, Parcial)Prostatectomias(Radical, H.P.B., Transvesical)Pieloplastias, NefropexiaSuprarrenalectomiaAmpliação Vesical, Re-implante UreteralRetroperitonioscopias

16. Eur Urol. 2008 May;55(5):1198-204Single-Incision, Umbilical Laparoscopic versus Conventional Laparoscopic Nephrectomy: A Comparison of Perioperative Outcomes and Short-Term Measures of Convalescence.Raman JD, Bagrodia, Cadeddu JAEur Urol 2010 Jan; 57(1):95-101Laparo-Endoscopic Single Site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison. Canes D, Aron M, Goldfarb DA, Desai MM, Gill IS > t.i.q. enxerto

17. QUAD-PORT

19. Volume 104 Issue 8 , Pages 1041 – 1182 (October 2009) (p 1136-1142)

20. Transumbilical Endoscopic Surgery – Are Special Devices Strictly Necessary?EAU Meeting 2009Stockholm Video Session AUA Meeting 2009 Chicago Video Session 7

22. Retroperitonioscopia"Adrenalectomy by Retroperitoneal Laparo-Endoscopic Single Site Surgery (LESS) - Case Report“Branco A. W., Branco F., A.J., Kondo W. Journal of the Society of Laparoendoscopic Surgeons JSLS

24. PfannenstielUrology. 2009 Sep;74(3):482-5. Epub 2009 Jul 30.A Pfannenstiel single-site nephrectomy and nephroureterectomy: a practical application of laparoendoscopic single-site surgery.Ponsky LE, Steinway ML, Hartke DM, Cherullo EEJ Endourol. 2010 Mar;24(3):429-32.Laparoendoscopic single-site pfannenstiel versus standard laparoscopic donor nephrectomy.Andonian S, Richstone L, KavoussI LR

25. Laparoscopic Nephrectomy through a Pfannenstiel IncisionInternational. Braz. J Urol - Video SessionBranco AW et alInternational Braz. J. Urol. - Accepted