| Theme | Present Status and Future Aspects of EUS | |
|---|---|---|
| Title | New Developments of Interventional EUS in UK | |
| Publish Date | 2005/10 | |
| Author | Keiichi Ikeda | Department of Surgical Oncology and Technology, St Mary's Hospital, London, UK / Department of Medical Physics, University College London, UK / Department of Endoscopy, The Jikei University School of Medicine |
| Author | Paul Swain | Department of Surgical Oncology and Technology, St Mary's Hospital, London, UK / Department of Medical Physics, University College London, UK |
| Author | Annette Fritscher-Ravens | Department of Endoscopy, St Mary's Hospital, London, UK |
| Author | Hiroshi Kakutani | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hisao Tajiri | Department of Endoscopy, The Jikei University School of Medicine |
| [ Summary ] | Transgastric endoscopic surgery has been developed to allow incisionless, minimally invasive treatment without requiring anaesthesia, laparoscopy or open surgery. The invention of new endosurgical methods and devices for application at EUS might promote development of a new type of surgery that would permit manipulation of structures deep within or outside the GI tract wall with high-quality, real-time US imaging. New sewing methods using EUS-FNA needle have been developed to perform transgastric gastroesophageal reflux surgery and transgastric tissue anastomosis. The aim of the study is to define the EUS anatomy of structures outside the gut that influence reflux, to place stitches in the median arcuate ligament, to perform posterior gastropexy, and to test the feasibility of crural repair under EUS control in pigs. We also developed methods of forming an anastomosis at flexible endoscopy, such as a gastrojejunostomy or cholecystoduodenostomy, when access to only one lumen is feasible. It was feasible to perform transgastric gastroesophageal reflux surgery and to form tissue anastomoses using the new sewing method at flexible endoscopy. Suturing under real-time EUS control offers significant advantages in terms of the further development of endosurgery. Linear EUS allows approaching to the target organ much more precisely, and is expected to lead to various transgastric endoscopic surgery combined with the new sewing method modified the EUS-FNA technique. | |