Endoluminal Surgery, New target for Hybrid Endo-Laparoscopic surgeon
Shahram.Nazari, MD1
(1)Department of Surgery, Erfan Hospital, Tehran, Iran
Although surgery within the lumen of the gut has been performed for many years, this has traditionally involved a laparotomy and enterotomy. Intraluminal surgery began with the advent of endoscopy. With the advances in flexible endoscopy, surgeons and gastroenterologists have been able to perform therapeutic procedures with instruments introduced through the working channel of flexible endoscopes. These procedures, however, have been mainly limited to technically minor ones, such as injection and cautery of bleeding ulcers and resection of polyps and small mucosal lesion (EMR & ESD). After the advent of Trans-Endoscopic Mucosectomy (TEM), intraluminal surgery developed. More recently, laparoscopic surgeons have been able to isolate the lumen of hollow organs as a separate working space. Laparoscopy-assisted intraluminal surgery is a novel alternative to open or laparoscopic surgery for a failed endoscopic endoluminal technique, minimizing the associated complications. Endoscopic resection of early cancers is restricted by the limited view of the endoscope, insufficient number of instrument channels, and inability to have adequate margins of resection without risking perforation. These cancers potentially can be treated by laparoscopy-assisted intraluminal surgery without resorting to major resection. This procedure is relatively easy to perform and oncologically effective. We present our experience in laparoscopy-assisted endoluminal surgery.
Author Address:
Shahram Nazari, MD. Consultant & Lecturer in Surgery, Department of General and Laparoscopic Surgery, Erfan Hospital, Tehran, Iran. No:36, Afarin St.,Alvand Ave.,Argentin Sq.,Tehran 1516636113,IRAN.
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