Current status of natural orifice translumenal surgery.

Translumenal access to the peritoneal cavity will have definite advantages in situations whereby the transcutaneous route into the peritoneal cavity is not optimal. For example, transgastric approach may decrease the risk of postoperative wound complications in patients who have marked obesity, as well as in patients who have anterior abdominal wall infection or severe scarring. Natural orifice translumenal surgery provides an exciting opportunity to improve surgical intervention using the skills, imagination, and ingenuity of endoscopists and endoscopic surgeons.