For surgeons, it has always been a necessary evil to make skin incisions on the abdomen to access the peritoneal cavity and surgically treat the pathologies of internal organs. The ideal, of course, would be if surgeons could root out disease without cutting into patients' bellies at all. Physicians have been steadily making progress toward that goal since the 1980s, when the introduction of laparoscopic tools allowed surgery to take a giant leap forward. Now physicians routinely access the abdominal cavity using several "keyhole" incisions, rather than using one large incision. But in the two decades since the advent of laparoscopy, surgeons have only inched closer to that ultimate ideal – incisionless surgery.
The number and size of ports of entry have diminished over the years, and a small number of innovative surgeons have even succeeded in performing truly scarless surgery using a NOTES approach. NOTES (natural orifice translumenal endoscopic surgery) is an experimental alternative to conventional surgery that allows surgeons to access the peritoneal cavity through the mouth, the rectum, or the vagina to perform surgery
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