Natural orifice transluminal endoscopic surgery: The true frontier of gastrointestinal endoscopy

Table 1 Evolution and key milestones in natural orifice transluminal endoscopic surgery

Ref.	Date	Model or setting	Access route	Procedure/innovation	Key contribution/outcomes
Kalloo et al[1]	2000	Porcine model	Trans-gastric	Diagnostic peritoneoscopy	First proof-of-concept of transluminal endoscopic access to the peritoneal cavity
Rao et al[2]	2008	Human	Trans-gastric	Appendectomy	First human NOTES procedure
Rattner et al[3]	2006	Consensus group	-	Established safety framework	Laid research and training foundations for clinical NOTES
Jamshidi et al[10]	2009	Human	Trans-gastric	Human magnetic compression gastroenterostomy	First human magnetic-assisted transluminal anastomosis
Liu et al[7]	2013-2014	Human	Trans-gastric	Ovarian cystectomy	First pure transgastric human NOTES
Liu et al[5]	2015	Human	Trans-rectal	Gallbladder preserving cholecystolithotomy	First pure organ-preserving NOTES procedure
Liu et al[6], Liu et al[7], Liu et al[8], Wang et al[9]	2018-2020	Clinical	Trans-rectal, trans-gastric, trans-vaginal	Appendectomy, gastroenterostomy	Expansion to transluminal therapeutic applications
Zhao et al[16]	2021-2023	Human	Trans-rectal	Balloon-assisted access and closure	Development of detachable balloon system reducing peritoneal contamination risk
Jamshidi et al[10], Ryou et al[11], Ryou et al[12], Thigpen et al[13], Simsek et al[15]	2023-2025	Clinical and Experimental	Trans-rectal, trans-gastric, trans-vaginal	Gallbladder, liver, pancreas, mediastinal interventions	Integration of robotics, magnetic platforms, and AI-assisted navigation into NOTES

NOTES: Natural orifice transluminal endoscopic surgery; AI: Artificial intelligence.