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Updated: May 1, 2026

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Submucosal tunneling techniques: current perspectives.

Hideki Kobara1, Hirohito Mori1, Kazi Rafiq2

  • 1Department of Gastroenterology and Neurology, Kagawa University, Miki-cho, Kita-Gun, Kagawa, Japan.

Clinical and Experimental Gastroenterology
|April 18, 2014
PubMed
Summary

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This summary is machine-generated.

The submucosal tunneling technique enhances endoscopic surgery safety and efficacy. This method, including per oral endoscopic myotomy, offers new possibilities for gastrointestinal procedures and diagnostics.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Endoscopic Procedures

Background:

  • Endoscopic submucosal dissection (ESD) has advanced with new techniques.
  • Submucosal tunneling allows safer access for endoscopic surgeries.

Purpose of the Study:

  • To review the advancements and applications of the submucosal tunneling technique.
  • To highlight its role in natural orifice transluminal endoscopic surgery (NOTES) and other procedures.

Main Methods:

  • Introduction of tunnels into the submucosa for endoscopic access.
  • Adaptation of the technique for esophageal myotomy (per oral endoscopic myotomy).
  • Application in removing gastrointestinal subepithelial tumors and endomicroscopy.

Main Results:

Keywords:
functional and motility disordersgastrointestinal subepithelial tumornatural orifice transluminal endoscopic surgeryperoral endoscopic myotomysubmucosal endoscopysubmucosal tunneling method

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  • Safer offset entry into the peritoneal cavity for NOTES.
  • Visual identification of gut layers, blood vessels, and tumors.
  • Creation of a mucosal flap to minimize leakage, enhancing safety and efficacy.

Conclusions:

  • The submucosal tunneling technique, with a mucosal safety flap, shows significant potential for future endoscopic developments.
  • It has established per oral endoscopic myotomy and expanded applications in tumor removal and diagnostics.
  • This technique represents a new discipline in submucosal endoscopic surgery.