We thank Dr. Alessiani for his comments and congratulate him for the excellent work done on NOTES in the animal lab.

NOTES techniques are in evolution; investigators from all over the world are working on NOTES procedures [1, 2]. We agree that nomenclature is important in communicating about these techniques and believe that if dissection is primarily performed with laparoscopic instruments, then the procedure is laparoscopy.

After working in the animal lab, we acquired the necessary skills and experience to translate our work into human NOTES surgery [3].

We are happy that more groups are embracing this interesting technique and we encourage work such as yours in the animal lab before proceeding to the human operating room.