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Endoscopic Cholesteatoma Surgery
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[LAPAROSCOPIC AND ENDOSCOPIC COOPERATIVE SURGERY].

Susumu Aikou, Sachiyo Nomura, Yasuyuki Seto

    Nihon Geka Gakkai Zasshi
    |September 1, 2018
    PubMed
    Summary
    This summary is machine-generated.

    Laparoscopic and endoscopic cooperative surgery (LECS) offers a safe approach for resecting gastric submucosal tumors. Newer techniques like NEWS and CLEAN-NET enhance safety by avoiding stomach perforation during tumor removal.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Minimally Invasive Surgery

    Background:

    • Laparoscopic wedge resections are standard for gastric submucosal tumors.
    • Laparoscopic and Endoscopic Cooperative Surgery (LECS) has emerged as a versatile technique for these resections.
    • Tumor location and size previously limited surgical options.

    Purpose of the Study:

    • To review the safety and applicability of LECS for gastric submucosal tumor resection.
    • To introduce novel LECS variations, Nonexposed Endoscopic Wall-Inversion (NEWS) and CLEAN-NET, designed to prevent tumor seeding.
    • To discuss the potential of LECS in gastric cancer surgery.

    Main Methods:

    • Description of the classic LECS procedure involving combined endoscopic submucosal dissection and laparoscopic seromuscular layer dissection.
    • Explanation of the NEWS technique, emphasizing laparoscopic suturing of the seromuscular layer before endoscopic mucosubmucosal incision.
    • Overview of CLEAN-NET as an endoscopic and laparoscopic approach without perforation.

    Main Results:

    • LECS procedures, including NEWS and CLEAN-NET, can be performed safely with adequate incision lines.
    • These techniques are applicable for resecting various submucosal tumors, such as gastrointestinal stromal tumors.
    • The methods avoid gastric perforation, mitigating the risk of tumor seeding.

    Conclusions:

    • LECS is a safe and effective method for gastric submucosal tumor resection, adaptable to different tumor characteristics.
    • NEWS and CLEAN-NET represent advancements in LECS, enhancing safety by preventing perforation and tumor seeding.
    • Successful implementation and further development of LECS require close collaboration between surgeons and endoscopists.