Pure natural orifice transluminal endoscopic surgery (NOTES)procedures are procedures performed using flexible endoscopes and instruments passed through the scopes' working channels.Many surgeons use a hybrid NOTES technique.What is the difference between the pure NOTES and hybrid technique?

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Many surgeons use a hybrid NOTES technique that combines laparoscopic visualization with natural orifice access.Using a transvaginal hybrid NOTES technique,the surgeon inserts a 3- or 5-mm access port at the umbilicus to create a pneumoperitoneum.The surgeon next inserts a rigid laparoscope into the abdominal access port to visualize entry of the vaginal access port from inside the abdomen and then moves the laparoscope to the vaginal access port.

Pure Natural Orifice Transluminal Endoscopic Surgery (NOTES)procedures Are Procedures Performed