| Theme | Technological Innovation of Digestive Endoscopy -- Toward the Next Generation of Endoscopic Medicine | |
|---|---|---|
| Title | Future Perspective of Laparoscopic and Endoscopic Cooperative Surgery | |
| Publish Date | 2016/09 | |
| 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 | Kojiro Eto | Division of Gastrointestinal Surgery, Cancer Institute Hospital |
| [ Summary ] | We developed a laparoscopic and endoscopic cooperative surgery (LECS) technique by combining laparoscopic gastric resection with endoscopic submucosal dissection, and used this procedure to resect gastric submucosal tumors (SMTs). We have applied LECS for over 100 patients with gastric SMTs. LECS has recently been approved for insurance coverage by the National Health Insurance plan in Japan. Recently, modified LECS procedures [ inverted LECS, a combination of laparoscopic and endoscopic approaches to neoplasia with a non‒exposure technique (CLEAN‒NET), and non‒exposed endoscopic wall‒inversion surgery (NEWS) ] were developed for dissection of malignant tumors that may seed tumor cells into the abdominal cavity. These LECS‒related procedures might prevent tumor seeding. In the future, the indications for LECS in early gastric cancer may also be expanded, once the benefit of using sentinel lymph node biopsy data has been established. When performed together, LECS and sentinel lymph node dissection could provide a minimally invasive surgical technique for adequate radical oncological resection of early gastric cancer. |
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