New Applications for Submucosal Tunneling in Third Space Endoscopy: A Comprehensive Review

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Therapeutics

Background:

• Third space endoscopy (TSE), a form of natural orifice transluminal endoscopic surgery, emerged a decade ago.
• TSE involves accessing the submucosal space between the intestinal mucosa and muscularis propria.
• This approach enables minimally invasive procedures while preserving mucosal integrity.

Purpose of the Study:

• To review the evolution and impact of third space endoscopy in therapeutic endoscopy.
• To explore various TSE techniques and their applications in treating gastrointestinal conditions.
• To discuss the efficacy, limitations, and potential of emerging TSE procedures.

Main Methods:

• Review of established and novel third space endoscopy techniques.
• Description of procedures such as peroral endoscopic myotomy and submucosal tunneling.
• Analysis of applications in treating motility disorders and neoplasms.

Main Results:

• TSE has revolutionized therapeutic endoscopy, offering minimally invasive options for gastrointestinal conditions.
• Procedures like peroral endoscopic myotomy are becoming accepted surgical alternatives due to safety and cost-effectiveness.
• Various TSE techniques allow for myotomies, resections, and dissections within the submucosal space.

Conclusions:

• Third space endoscopy provides a minimally invasive approach to complex gastrointestinal conditions.
• TSE procedures offer significant advantages over traditional surgery, including reduced invasiveness and improved safety.
• Continued development of TSE techniques expands therapeutic endoscopic capabilities.