[Microscopic endoscopic tumor surgery. What is possible?]

The technique of transanal endoscopic microsurgery was used to remove sessile polyps which involved the whole circumference and were up to 8 cm long. This defect is always closed endoscopically by transverse continuous suture; in case of segmental resection end-to-end anastomosis is performed. The complication and recurrence rate is lower than that of conventional procedures. Moreover the postoperative course is shorter and the patient is free of pain. A second example of minimal invasive surgery is the endoscopic-microsurgical dissection of the esophagus. Here the whole esophagus is exposed endoscopically using the newly developed operating mediastinoscope. The definite superiority of this new technique to conventional procedures was proven by a controlled randomized experimental animal study.