This document discusses the history and development of natural orifice transluminal endoscopic surgery (NOTES). It describes early developments in the 18th century using colpotomy and ventroscopy. In the 1930s, techniques like colpolaparoscopy were introduced using rigid instruments through the vagina. It then outlines continued developments using both rigid and flexible instruments through the vagina and cul-de-sac for procedures like cholecystectomy, appendectomy, and notes how this approach has been adopted worldwide.

1. 自然腔道内镜手
术
02/02/18 1
阴道内窥镜手术的历史

2. 自然腔道内 手镜 术
02/02/18 2

3. 02/02/18 3
阴道内镜检查进展
介绍

4. 02/02/18 4
解剖学
The description of the recto-
uterine pouch is credited to
the work of Dr. James
Douglas.
“A description of the peritoneum
and that part of the membrana
cellularis which lies outside”
London, 1730.

5. 02/02/18 5
VENTROSCOPIA
A resourceful use of colpotomy
was presented by Dr. Dmitri Ott at
the Meeting of The Gynecology
and Obstetrical Society of Saint
Petersburg in Russia held on April
19, 1901; that was the introduction
of Ventroscopy.

6. 02/02/18 6
Ott 博士出版
Ventroscopia

7. 02/02/18 7
1937 年维也纳医学会
会议
 Dr. Emanuel Klaften presented the
technique of Colpolaparoscopy.
 Dr. Klaften designed an optical
instrument with a light source and
a 90-degree angle lens.

8. 02/02/18 8
Klaften
Colpolaparoscope 博士

9. 02/02/18 9
CULDOSCOPY
 Drs. A. Decker and T. Cherry
described Culdoscopy in 1944.
The patients were in the knee-
chest posture, which allowed for
better visualization. Most of the
studies were performed at
Knickerbocker Hospital in
Manhattan, New York.

10. 02/02/18 10
Topic Two

11. 02/02/18 11

12. 02/02/18 12
反式阴道液体腹腔
镜 / Fertiloscopy
 Transvaginal Hydrolaproscopy (THL), a
technique related to culdoscopy, was
introduced in 1998 utilizing new
technology. Placing a 3mm in diameter
culdoscope, and using normal saline as
a distention media, this office-based
procedure is performed with the patient
in the lithotomy position, and anesthesia
is not required. The procedure is used
as a diagnostic tool for infertility, pelvic
pain, and endometriosis. Other minor
operative procedures could also be
done.

13. 02/02/18 13
反式阴道液体腹腔
镜 / Fertiloscopy
 Details about this topic
 Supporting information and
examples
 How it relates to your audience

14. 02/02/18 14
灵活 Culdoscopy 1999
 Flexible instrument technology is used
for the visualization of the pelvic. This
device is used with the patient in the
knee-chest posture. The flexible
culdoscope gives a visualization range
from 0 degree to 180 degrees. This
permits the viewing of areas in the blind
spots of rigid instruments like the
bladder, anterior uterine surface, and the
posterior cul-de-sac.

15. 通 直 子 囊 合过 肠 宫 结
迷 腹腔 的内你 镜 窥镜
检查
CULDOLAPAROSCOPY
02/02/18 15

16. 02/02/18 16
CULDOLAPAROSCOPY
Dr. Tsin began, in 1998, utilizing a vaginal
port, specifically to assist with
minilaparoscopy. The project began
utilizing a 12 mm trocar inserted into the
cul-de-sac under minilaparoscopic
surveillance. This is a new concept
where the function of the ports change
depending on the nature or stage of the
procedure. The surgeon has the
opportunity to utilize different size
scopes, and the team has the ability to
operate from different angles and with
good triangulation.

17. 02/02/18 17
 尾切除阑 术 Culdolaparoscopic
 ( 1998)
Real Life
 Give an example or real life
anecdote
 Sympathize with the audience’s
situation if appropriate
阑阑尾切除 尾切除阑 术
术尾切阑尾切除术除术
)

18. 02/02/18 18
CULDOLAPAROSCOPY
During 1999, Dr. Tsin et al. began to use
this approach in the visualization and
operation during vaginal hysterectomy.
This time, the resemblance to
ventroscopy was obvious. We were able
to insufflate and visualize the abdomen,
and perform simultaneous
cholecystecomies, difficult
oophorectomies, and
salpingoophorectomies. Later, the
posterior colpotomy was used for the
same task.

19. 02/02/18 19
胆囊切除 通术 过阴
道 (1999)
Culdolaparoscopic
Cholecystectomy
During Vaginal
Hysterectomy.
Tsin DA, Sequeira J,
Giannikas G.
JSLS 2003;7:171-
172.

20. 02/02/18 20
Kallo et al. (2004)
Gastrointest Endosc. 2004
Jul;60(1):114-7
 Flexible transgastric
peritoneoscopy: a novel
approach to diagnostic and
therapeutic interventions in the
peritoneal cavity.
 Division of Gastroenterology,
Johns Hopkins Hospital, Baltimore,
Maryland USA.

21. 02/02/18 21
然后来了 NOTES

22. 02/02/18 22
迷 腹腔 助你 镜帮
Minilaparoscopy-Assisted
Natural Orifice Surgery
Daniel A. Tsin, MD, Liliana T.
Colombero, MD, Johann
Lambeck, MD, Panagiotis
Manolas, MD
JSLS (2007)11:24–29
100 cases (human experience)

23. 02/02/18 23
胆囊切除 通 道术 过阴
 1999, August 20. Tsin DA, et al.
 2007, March 13. Zorron R, et al.
 2007, March 20. Bessler M, et al.
 2007, April 2. Marescaux J, et al.

24. 02/02/18 24
胆囊切除 通 道术 过阴
 1999, August 20.
Tsin DA, et al.
 2007, March 13.
Zorron R, et al.
 2007, March 20.
Bessler M, et al.
 2007, April 2.
Marescaux J, et al.
Rigid Instruments Flexible Instruments
Flexible Instruments Flexible Instruments

25. 02/02/18 25
然后在世界各地

26. 02/02/18 26
 Angel Cuadrado-Garcia, MD, PhD,
from the Department of General
Surgery, Hospital Son Llatzer,
Palma de Mallorca, Spain,
reported the safety of the hybrid
technique (MANOS) in
cholecystectomy as an alternative
to conventional laparoscopic
cholecystectomy.
安全

27. 02/02/18 27
病人 意度满
 J Laparoendosc Adv Surg Tech A.
2010 Mar;20(2):119-21.
 Postoperative patient attitudes
and perceptions of transvaginal
cholecystectomy.
Tsin DA, Castro-Perez R, Davila MR,
Davila F.

28. 02/02/18 28
先 的柔性内进 窥镜
The Transport advanced operating
endoscope [USGI Medical, San Juan
Capistrano, California].
The Cobra triangulating scope [USGI
Medical, San Juan Capistrano,
California].
The Olympus R [Olympus, Center
Valley, Pennyslvania] is a
commercially available dual channel
operating scope.

29. 02/02/18 29
The Eagle Claw [Olympus, Center
Valley, Pennsylvania] suturing
device with a semi-circular needle.
Transdouglas Endoscopic Device
更 活的内灵 窥镜

30. 02/02/18 30
活的 器灵 仪
Novare
Covidien
Ethicon Endosurgical

31. 02/02/18 31
忠告
 ASERNIP-S
 NOSCAR
 NESA/NOS

32. 02/02/18 32Dr. Guillermo Dominguez, Poza Rica, Mexico (2008)
磁铁

33. 02/02/18 33
Dr. Fausto Davila
Poza Rica, Mexico
(2008)
子钩 / 子钩

34. 02/02/18 34
尾切除阑 术
J Am Assoc Gynecol Laparosc.
2001 Aug;8(3):438-41.
Operative culdolaparoscopy:
a new approach
combining operative
culdoscopy and
minilaparoscopy.
Tsin DA, Colombero LT,
Mahmood D, Padouvas J,
Manolas P.
Surg Endosc. 2008 May;22(5):1343-
7. Epub 2008 Mar 18.
Transvaginal endoscopic
appendectomy in humans: a
unique approach to NOTES--
world's first report.
Palanivelu C, Rajan PS, Rangarajan
M, Parthasarathi R, Senthilnathan
P, Prasad M.
Rigid Instruments Flexible Instruments

35. 02/02/18 35
切除肾 术
Feasibility of Transvaginal Natural Orifice
Transluminal Endoscopic Surgery–Assisted
Living Donor Nephrectomy: Is Kidney
Vaginal Delivery the Approach of the
Future?
Antonio Alcaraz, Mireia Musquera,
Lluis Peri, Laura Izquierdo, et al.
European Urology. 2011; 59:1019–1025.

36. 02/02/18 36
乙状 切除结肠
Lacy AM, Delgado S, Rojas OA, Almenara R,
Blasi A,Llach J. MA-NOS radical sigmoidectomy:
report of a transvaginal resection in the human.
Surg Endosc 2008; 22:1717-1723.
Burghardt J, Federlein M, Müller V, Benhidjeb T,
Elling D, Gellert K. [Minimal invasive
transvaginal right hemicolectomy: report of the
first complex NOS (natural orifice surgery)
bowels operation using a hybrid approach]
Zentralbl Chir 2008; 133:574-576.

37. 02/02/18 37
Secured Independent Tools迷 机器人你
科学实验

38. 02/02/18 38
自然腔道内 手镜 术
www.culdoscopy.comwww.culdoscopy.com
感 的 注谢您 关
欲了解更多信息，请：