In the field of minimally invasive surgery , Natural Orifice Transluminal Endoscopic Surgery (NOTES) has emerged as a groundbreaking technique. It aims to access internal organs through natural body orifices, such as the mouth, vagina, or rectum, thereby eliminating the need for external incisions. This article explores the latest advancements, clinical applications, and challenges associated with NOTES, including instrumentation, access routes, and patient selection criteria. NOTES offers several advantages over traditional open surgery and conventional laparoscopic procedures . By using natural orifices, it avoids visible scars and reduces postoperative pain. Additionally, it minimizes the risk of infection and shortens recovery time. The development of flexible endoscopic instruments and advanced imaging technologies has facilitated the progress of NOTES. One of the key advancements in NOTES is the development of specialized instruments. Flexible endoscopes , with their maneuve...