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Laser-supported diaphanoscopy: a new technique in laparoscopic-endoscopic rendezvous procedures allowing better and
M Patrzyk1, K Ludwig, C D Heidecke
1Department of Surgery, Clinic of General Surgery, Visceral, Thoracic and Vascular Surgery, Ernst-Moritz-Arndt-University Hospital, Friedrich-Loeffler-Str. 23b, 17489, Greifswald, Germany. patrzyk@uni-greifswald.de
Background:
Locating gastrointestinal stromal tumors (GIST) during laparoscopic surgery continues sometimes to be difficult and inaccurate. In addition, the methods used for tumor mapping often do not lead to precise location of tumors. Also, they are too expensive or too complex for an easy surgical approach. Furthermore, the standard wedge resection often sacrifices too much healthy tissue.
Methods:
The current study introduces an innovative tissue-sparing method using laser-supported diaphanoscopy (Endolight) for exact location of GIST during laparoscopic surgery. The instrument was developed by the authors' group. This study retrospectively evaluated two groups of patients experiencing GIST. The first group of 10 patients was treated by standard wedge resection. The second group of 10 patients was treated by Endolight-guided laparoscopic resection during a laparoscopic-endoscopic rendezvous procedure.
Results:
After precise location of GIST using Endolight, all patients could be successfully resected. The largest resection margins using Endolight (9.8±3.8 mm) were significantly smaller than the largest resection margins using wedge resection (stapler) without Endolight (21.5±9.1 mm; p<0.0001). The average surgery time for the group treated by standard wedge resection was 65 min (range, 28-108 min). The surgery time required for the group treated by Endolight-guided resections ranged from 48 to 189 min (average, 123 min). The number of marks used for Endolight resections ranged from four to seven depending on the location and size of the tumor.
Conclusion:
The reported technique allows the precise location of GIST, leading to exact and tissue-sparing transmural laparoscopic resection of these tumors compared with standard wedge-resection. Laser-supported diaphanoscopy using the newly developed innovative device offers new perspectives and a highly effective technique for resecting GIST that combines an endoscopic with a laparoscopic approach.
Insights
Laser-supported diaphanoscopy (Endolight) precisely locates gastrointestinal stromal tumors (GIST) for tissue-sparing laparoscopic resection. This innovative technique offers improved accuracy and reduced margins compared to standard wedge resection for GIST treatment.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Accurate localization of gastrointestinal stromal tumors (GIST) during laparoscopic surgery remains challenging.
- Existing tumor mapping methods lack precision, are costly, or overly complex.
- Standard wedge resection often results in excessive sacrifice of healthy tissue.
Purpose of the Study:
- To introduce and evaluate an innovative tissue-sparing method for precise GIST localization during laparoscopic surgery.
- To compare the efficacy of laser-supported diaphanoscopy (Endolight) with standard wedge resection for GIST resection.
Main Methods:
- Development of a novel laser-supported diaphanoscopy device (Endolight) for GIST localization.
- Retrospective evaluation of two patient groups: 10 treated with standard wedge resection and 10 with Endolight-guided laparoscopic resection.
- Laparoscopic-endoscopic rendezvous procedure utilized for Endolight-guided resections.
Main Results:
- Endolight enabled precise GIST localization and successful resection in all patients.
- Endolight group had significantly smaller resection margins (9.8±3.8 mm) compared to standard wedge resection (21.5±9.1 mm; p<0.0001).
- Average surgery time was 65 min for standard resection and 123 min for Endolight-guided resection.
Conclusions:
- Laser-supported diaphanoscopy (Endolight) facilitates precise GIST localization for exact, tissue-sparing laparoscopic resection.
- The Endolight technique offers a highly effective approach for GIST resection, combining endoscopic and laparoscopic methods.
- This innovative device provides new perspectives for improved GIST management in surgical oncology.
