[Novel Procedure of Early Mucosal Resection and Late Snare Sero-Muscular Resection in Closed LECS(Easy Closed...

Laparoscopy endoscopy cooperative surgery(LECS)is an excellent surgical procedure that utilizes the advantages of both methods in gastrointestinal tumor(GIST)and localized tumor. Closed LECS is a more promising procedure that enables to avoid tumor exposure and dissemination in high-risk tumors. However, this technique may be technically challenging for most endoscopists because it may have various pitfalls to keep safe surgical margins and high technical demands to resect sero-muscular. Therefore, we invented a novel, safe and easy procedure in closed LECS, by early endoscopic mucosal resection before setting spacer, and late snare sero-muscular resection followed by all-layer suturing to close the mucosal defect easy closed LECS.