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Item Pre-clinical Training for New Notes Procedures: From Ex-vivo Models to Virtual Reality Simulators(Elsevier, 2016-04) Gromski, Mark A.; Ahn, Woojin; Matthes, Kai; De, Suvranu; Department of Medicine, IU School of MedicineNatural orifice transluminal endoscopic surgery (NOTES) is a newer field of endoscopic surgery that allows for scarless treatment of pathologic entities, using novel transluminal approaches. There has been a shift of focus from a clinical and research standpoint from the development and dissemination of "first-generation" NOTES procedures to "new NOTES" procedures that traverse the mucosa of luminal structures, yet do not stray far into the peritoneal cavity. It has been a challenge to find appropriate and effective ways to train gastroenterologists and surgeons in these novel approaches. We review the importance of simulation in training and discuss available simulation options.