Single-Incision Laparoscopic Surgery (SILS)and Natural Orifice Endoscopic Transluminal Surgery (NOTES)are

Single-incision laparoscopic surgery (SILS) and natural orifice endoscopic transluminal surgery (NOTES) are minimal access surgery (MIS) approaches and share many indications,implications,and instrument platforms.The benefits and drawbacks essentially parallel each other;however,there are several unique differences that set each apart and define their application.What is the one question that needs to be answered to determine if SILS should be considered in lieu of NOTES?

A) What is laparoscopic endoscopic single-port surgery (LESS) ?
B) Will cost of instrumentation be the demise of MIS?
C) Is the umbilicus a natural orifice?
D) Is the risk of infection too great to use the rectum as a portal for surgery?