摘要
Natural-orifice specimen-extraction surgery(NOSES)for colorectal disease is not a new surgical procedure,although its lack of penetration into common colorectal surgical practice may make it a relatively new procedure.Stewart et al.[1]were among the first to report the extraction of a colectomy specimen through the vagina in 1991 and,shortly thereafter,Franklin et al.[2]published the first report of partial colectomy with naturalorifice specimen extraction(NOSE)via the anus.Since then,there have been several publications on the extraction of both malignant and benign colonic diseases from the caecum to the distal rectum through natural-orifice extraction sites.Unlike procedures such as laparoscopic cholecystectomy,which was introduced in 1985 and rapidly diffused into the surgical community over a 2-to 3-year period,the dispersion of NOSES has not been equivocal[3].As there are several reasons why some new surgical innovations may be taken up more quickly than others,the adoption curves of new procedures can take many forms.However,the tipping point that describes the onset of the peak rate of diffusion of the new technology usually occurs after the first 10%–20%of users have adopted it[3].From a global perspective,the adoptions curve for NOSES has not obtained a peak rate of diffusion and appears to have arrested in the developmental and explorative phase of innovation[3].
