The Vall d'Hebron University Hospital has hosted the 13th edition of the International Notes-WIDER-Barcelona course, which includes conferences and practical workshops on gastroenterology and surgery and digestive endoscopy every year since 2007.The course, which took place on November 25 and 26, has brought together a hundred international surgeons and experts in these fields in order to update them in the immediate future of transluminal endoscopic surgery for natural orifices (or Notes) , since "they are less invasive methods and that allow to avoid incisions and external scars in the abdominal surgeries, and with faster recovery of the patient", according to explains the Dr. Josep Ramon Armengol, director of the course and the WIDER-Barcelona Institute. Interventional therapeutic techniques derived or related to this type of surgery have also been presented with live transmissions and with simultaneous discussion from the endoscopy rooms in the auditorium.In addition to the theoretical conferences, participants were able to attend practical and interactive sessions in two operating theaters of the Digestive Endoscopy Service and the Vall d'Hebron Research Institute (VHIR) thanks to video transmission. The practical sessions have allowed the demonstration of techniques of anesthesia, intubation and sounding, pathways such as anastomosis, transgastric cholecystectomy, transvaginal, appendectomy, and hinging closure techniques, endoscopic retrograde cholangeoproteoteography (CPRE), echoendoscopy of support and therapeutics and access to mediastin, POEM, LECS, et cetera.In addition, this year's novelty has been explained the premiere of the new radiological robot of the https://www.vallhebron.com/en/multimedia/vall-dhebron-digestive-endoscopy-world-leader Digestive Endoscopy Service, which last July operated a patient with a biliocopic and pulmonary fistula. "A resection of a liver tumor with right hepatectomy was done and the closure was done thanks to the assistance of the robot, called Artis Pheno," says Dr. Armengol.The course has been led by Dr. Josep Ramon Armengol, Dr. Manuel Armengol Carrasco, head of the VHIR General Surgery Research Group, Dr. Antonio José Torres García and Dr. Joan Dot Bach, Head of the Digestive Endoscopy Service, and has received the support of Vall d'Hebron University Hospital and VHIR and the collaboration of the "La Caixa" Community Projects Foundation and the Autonomous University of Barcelona.