Single access laparoscopic surgery: Complementary or alternative to NOTES?

In recent years, single access laparoscopic surgery (SALS) and natural orifice translumenal endoscopic surgery (NOTES) have gained interest from both clinical and industrial point of view, with the increased development of different laparoscopic instruments, production of various access ports, and improvement of operative endoscopes. The main advantages stimulating these two approaches are the cosmetic result, the rapid recovery of the patient, and the reduced need for pain killers. SALS and NOTES are in part complementary and in part alternative techniques. Currently, SALS is much simpler and technically easier than NOTES.