Indications for transgastric NOTES (natural orifice transluminal endoscopic surgery) studied so far are limited to intra-abdominal surgery. The next question to be addressed is whether this access can be extended further.
Here we show how NOTES can be extended to the chest working in the esophageal submucosal space, accessed from the esophageal lumen, to perform esophageal myotomy. Different transesophageal access and closure techniques are also shown.