The Role of Natural Orifice Specimen Extraction in Modern Surgery: A Narrative Review

TL;DR

NOSE is a minimally invasive surgical technique that removes specimens through natural orifices, reducing recovery time and complications while maintaining safety and effectiveness.

Contribution

This paper reviews the current state of NOSE techniques, highlighting their benefits and areas needing further research.

Findings

NOSE reduces postoperative pain and recovery time compared to traditional methods.

Robotic-assisted NOSE can address anatomical challenges and expand procedure applicability.

More research is needed on long-term outcomes and economic impacts of NOSE.

Abstract

Natural Orifice Specimen Extraction (NOSE) is an innovative, minimally invasive technique that combines laparoscopic or robotic resection with specimen retrieval through natural orifices, eliminating the need for abdominal extraction incisions. By avoiding additional incisions, NOSE reduces postoperative pain, wound complications, and recovery time, while preserving oncologic integrity. It has been widely applied in colorectal and gynecologic procedures, demonstrating feasibility, safety, and improved patient-centered outcomes. This review synthesizes current evidence on surgical indications, technical considerations, postoperative recovery, complications, oncologic outcomes, and patient-reported metrics. Robotic-assisted NOSE is also discussed as a means to overcome anatomical challenges and expand procedural applicability. Despite promising results, gaps remain in long-term functional outcomes, standardized protocols, and economic analyses. Continued research is needed to refine techniques, broaden indications, and optimize patient outcomes. NOSE represents a transformative approach within minimally invasive surgery, potentially improving recovery, satisfaction, and overall surgical quality.

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