Natural orifice transluminal endoscopic surgery (NOTES), an emerging minimally invasive surgery (MIS) technique, eliminates external incisions by gaining access to the peritoneal cavity through a natural orifice (vagina, anus and esophagus). This provides various advantages, such as no visible scarring, less pain and a lower anesthesia requirement [1]. Although NOTES has gathered increasing attention in medical science and the feasibility has been demonstrated by many researchers, it is still uncommon in practical clinical human surgeries due to a list of potential constraints [2]. These include limited space, inefficient actuation device, lack of visual/tool triangulation, and lack of dexterous multitasking tools. Olympus provides a commercial “R” scope which has two independent curvature sections and works with several instrument channels to conduct NOTES. However, manipulating the scope is quite complicated and requires several operators to cooperatively control it [3].

Based on our previous work on NOTES...

You do not currently have access to this content.