CIMIT ModelClinical ImpactCommunity: CoLabContact Us
Minimally Invasive Surgery: (NOTES)
Natural Orifice Translumenal Endoscopic Surgery


CIMIT’s Minimally Invasive Surgery progam is focused on making surgery safer and more precise, exploring the next generation of less invasive surgical therapy. Recent projects involve developing tools and procedures for Natural Orifice Translumenal Endoscopic Surgery (NOTES), which could make surgery completely free of incisions, while drastically reducing the chances of infection, pain, and disability.  Through the NOTES initiative, many complex surgeries could eventually become outpatient procedures. 

Using newly developed NOTES devices, no external incision is necessary as surgeons gain access to the surgical field through a natural orifices. The hypothesis is that by avoiding incisions in the abdominal wall, risks of infection, pain and disability will be minimized and recovery either shortened or eliminated. Many procedures could be so radically improved that patients might even be able to return to a normal routine immediately.

In 2008, CIMIT awarded its $2.1 million, three-year, CIMIT Strategic Project grant to a multi-disciplinary, multi-institutional team studying and advancing the surgical procedure NOTES. With this award, CIMIT’s investment in NOTES research will top $3 million overall, making CIMIT the largest financial sponsor of this technology worldwide.


Medical News Today: World First: Rectal Tumor Removed Through Anus, Avoiding Painful Abdominal Incisions

VIDEO: Transanal Endoscopic Microsurgery (TEM)

Additional Coverage on TEM Surgery: EndoNurse, EurekAlert!, LittleAbout,,,

6.22.09 You Want To Take My What Out Of My Where? Hospitals Experiment With Orifice Surgery

  • Projects
  • Publications
  • In The News
Current Funded NOTES Projects
2010-2008 David Rattner, MD, and
Chris Thompson, MD, MSc
Massachusetts General Hospital & Brigham and Women’s Hospital Strategic Project on Natural Orifice Translumenal Endoscopic Surgery
2008 Marvin Ryou Brigham and Women’s Hospital Magnetic Retraction for Advanced NOTES Procedures
2008 Marvin Ryou Brigham and Women’s Hospital Systematic Mapping of NOTES Access Sites in Human Cadavers
Recent Publications by CIMIT Investigators
Willingham, F. F., Gee, D.W., Lauwers, G., Brugge, W. R., Rattner, D. W. Surg Endosc.
Natural Orifice Transesophageal Mediastinoscopy and Thoracoscopy 2008
Alam, H. B., Shults, C., Ahuja, N., Ayuste, E. C., Chen, H., Koustova, E., Sailhamer, E. A., Li, Y., Liu, B., de Moya, M., Velmahos, G. C. Resuscitation
Sep 4, 2007
Impact of Resuscitation Strategies on the Acetylation Status of Cardiac Histones in a Swine Model of Hemorrhage 2007
Sailhamer, E. A., Chen, Z., Ahuja, N., Velmahos, G. C., de Moya, M., Rhee, P., Shults, C., Alam, H. B. J Am Coll Surg 204(4):642-53 Profound Hypothermic Cardiopulmonary Bypass Facilitates Survival without a High Complication Rate in a Swine Model of Complex Vascular, Splenic, and Colon Injuries 2007
Velmahos, G. C., Spaniolas, K., Duggan, M., Alam, H. B., Tabbara, M., de Moya, M., Vosburgh, K. J Trauma 63(2):285-8, discussion 288-90 Abdomainal Insufflation for Control of Bleeding After Severe Splenic Injury 2007
Stahl, J.E., Goldman, J.M., Rattner, D.W., Gazelle, G.S. J. Surg Res. Related Articles, Links Adapting to a New System of Surgical Technologies and Perioperative Processes Among Clinicians 2007 Jan. 31 (Epub ahead of print)
Ryou, M., Rattner, D., Pai, R., Thompson, C. Surg Endosc. 12:677-80 Evaluating an Optimal Gastric Closure Method for Trans-Gastric Surgery 2007
Pai, R., Fong, D.G., Bundga, M.E., Odze, R.D., Rattner, D.W., Thompson, C.C. Gastrointestinal Endoscopy 64:428-34 Transcolonic endoscopic cholesystectomy: a NOTES survival study in a porcine model. 2006
Rattner, D.W. Surg Endosc 20:1802-8 Innovation, Disruption and the perils of success. 2006
Rattner, D.W., Kalloo, A. Surg Endosc. 20:329-33 The ASGE/SAGES Working group on Natural Orifice Transluminal Endoscopic Surgery WHITE PAPER 2006
Video: CIMIT Life-Saving Innovation in Early Stage of Trauma.
Project Leaders

David Rattner, MDDavid Rattner, MD

Chris Thompson, MD, MScChris Thompson, MD, MSc,



CIMIT Community

Sign up to keep informed about the CIMIT Minimally Invasive Surgery Program and Community.

Enter your email in form below:

Related Links

VIDEO: David Rattner at Ideas Boston

VIDEO Q&A with David Rattner, MD:
» What is NOTES?
» NOTES vs. Endoscopy
» What is TEM?
» TEM Procedure and Collaboration
» What is the Boston-based NOTES Initiative?
» Is NOTES an Improvement over Traditional Laparoscopic Procedures
» What Procedures Might Benefit from the NOTES Approach?
» What is a Typical Minimally Invasive Thoracic Procedure?
» What is the Potential for NOTES?
» NOTES vs. Single-Port Surgery
» The Evolution of NOTES
» The Role of CIMIT
» When might Patients Benefit from NOTES?

NOSCAR: Natural Orifice Surgery Consortium for Assessment and Research

ASGE: American Society for Gastrointestinal Endoscopy

SAGES: Society of American Gastrointestinal and Endoscopic Surgeons



Press Releases &
Fact Sheets

» July 2010: NOTES Progress Report

Strategic Project Award: CIMIT supports NOTES initiative with $2.1M grant

CIMIT Strategic Project Fact Sheet

NOTES Facts Sheet

NOTES: A Clinical Review


Integrated Clinical EnvironmentsNeuroHealth, PTSD & TBI Industry I Foundation Engagement Homebase & Warfighter CareAccelerator

CIMIT does not rate, endorse, recommend or prescribe any products, procedures or services. Subscribe to CIMIT News in RSS

Contact the Webmaster Site Acknowledgements Copyright © 2011 CIMIT. All rights reserved. site map linking policy privacy