Editorial introductions

Current Opinion in Gastroenterology was launched in 1985. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of gastroenterology is divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. Section Editors Chung OwyangFigure 1Professor Owyang is currently Professor of Internal Medicine and Chief of the Division of Gastroenterology at the University of Michigan in Ann Arbor, Michigan. He also holds the H. Marvin Pollard Chair in Gastroenterology. He received his MD degree from McGill University and completed his post graduate training at the Mayo Clinic, USA. In 1979 he joined the medical faculty at the University of Michigan where currently he holds numerous committee and administrative appointments. He serves as Director of the Marvin Pollard Institute for Medical Research, Director of the Gastrointestinal Physiology Laboratory and is a member of numerous prestigious national and international organizations. He was a member of the National Institute of Health Study Section, the Federal Drug Advisory Board (FDA) and the American Board of Internal Medicine. He has also served on the Council of the American Gastroenterological Association and chaired the International Committee. He served as the President of the American Motility Society in 2000–2004. Professor Owyang's work has focused on the molecular mechanisms of information processing in the enteric nervous system. His research has provided important insights into the pathophysiology and treatment of human disease states which has had important physiological and clinical implications, particularly in the treatment of chronic pancreatitis and irritable bowel syndrome. His most recent studies include the purification and characterization of the role of CCK-releasing peptide in health and in chronic pancreatitis. In addition, his laboratory is also doing studies to investigate the circuitry of the enteric nervous system in different regions of the GI tract and determine the mechanism of information processing. In recognition of his outstanding achievements in clinical research Professor Owyang received the prestigious Joseph B. Kirsner Award in Gastroenterology and was inducted as a honorary member of the Royal College of Physicians, Thailand. Professor Owyang takes pride in the over 25 fellows he has trained, many of whom are now important contributors in the field of gastroenterology. Professor Owyang authored more than 250 publications and co-authored with Professor Tadataka Yamada the new Textbook of Gastroenterology which is considered by many to be the best in its field. William R. BruggeFigure 2In this issue we have introduced a new frontier for endoscopy, transgastric endoscopy. This is an area of active investigation in many endoscopic research laboratories, but few human studies have been performed. The animal studies have suggested that these new techniques could have widespread applications in the performance of procedures in the peritoneal cavity. There are two potential advantages for NOTES (natural orifice translumenal endoscopic surgery) endoscopy and surgery. Most important, this technique could substantially reduce post-operative time and pain. Secondly, NOTES may broaden the ability of laparoscopic surgery to provide resection of occult or retroperitoneal structures. Thus far a range of diagnostic procedures have been demonstrated in animal trials, including peritoneoscopy, peritoneal and serosal sampling, and solid organ biopsies. The interest in transgastric peritoneoscopy is based upon the potential for high resolution flexible endoscopic examination of the peritoneal cavity. It is not obvious what a flexible endoscopic exam could offer that could not be provided by laparoscopy. It is conceivable that enhanced imaging abilities of endoscopy might be more sensitive for the detection of occult peritoneal metastasis or an atypical mycobacterium infection in the periteoneal cavity. The NOTES procedures will require the collaboration between GI endoscopists and GI surgery. In our institution, this organization was relatively easy to achieve because the two departments freely communicate and collaborate. This team-building may be more of a challenge in other environments. In terms of building expertise in therapeutic NOTES procedures, collaboration between laparoscopic surgeons and therapeutic endoscopists is critical. Although there are several obvious procedures that could become part of the NOTES armamentarium, it is difficult to imagine how NOTES procedures will significantly improve the safety and comfort of laparoscopic cholecystectomy, appendectomy, and tubal ligation. On the other hand, there are likely to be procedures that cannot be readily and safely performed with laparoscopy; for example, distal pancreatectomy, full thickness gastric resection, and retroperitoneal resection (e.g. adrenalectomy). NOTES may provide a lower risk procedure with fewer post-operative complications. In the coming year we will witness a surge in the number of publications focusing on NOTES procedures. It will be critical that the readers, reviewers, and editors maintain a healthy skepticism and an open eye to innovation. Stay tuned.

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