| Theme |
New Developments in Laparoscopy and Endoscopy Cooperative Surgery (LECS) |
| Title |
Classical LECS |
| Author |
Tatsuo Matsuda |
Division of Gastrointestinal Surgery, Cancer Institute Hospital |
| Author |
Naoki Hiki |
Division of Gastrointestinal Surgery, Cancer Institute Hospital |
| Author |
Souya Nunobe |
Division of Gastrointestinal Surgery, Cancer Institute Hospital |
| Author |
Itaru Yasufuku |
Division of Gastrointestinal Surgery, Cancer Institute Hospital |
| Author |
Atsushi Kumagai |
Division of Gastrointestinal Surgery, Cancer Institute Hospital |
| Author |
Manabu Ohashi |
Division of Gastrointestinal Surgery, Cancer Institute Hospital |
| [ Summary ] |
We developed a laparoscopy and endoscopy cooperative surgery (LECS) technique, which combines laparoscopic gastric resection with endoscopic submucosal dissection (ESD), and have used it to resect gastric submucosal tumors. In this procedure, the tumor location and an appropriate resection line are confirmed endoscopically, which is followed by submucosal dissection using intraluminal endoscopy. The seromuscular layer is then dissected endoscopically or laparoscopically. The advantages of LECS are that the tumors are observed both intra‒ and extraluminally and that the gastric wall is dissected layer‒by‒layer. These advantages make it possible to resect the tumor with a minimal margin and less stomach deformation. LECS is a safe and simple procedure and can be performed regardless of tumor location.
We first applied LECS to gastric submucosal tumors without ulcerative lesions owing to fear of tumor cell seeding into the peritoneal cavity. Therefore, we named the procedure 'Classical LECS'. Recently, we applied Classical LECS to submucosal tumors with ulcerative lesions and early gastric cancer that would have been difficult to treat with ESD using inverted LECS with the crown method. In this report we introduce the Classical LECS (Inverted LECS with Crown Methods) technique in detail. |