Endoluminal Surgery

Abstract

The development of laparoscopic surgery has provided minimally invasive surgeons with advanced laparoscopic instrumentation and high definition imaging. The resulting surgical expertise and technology has now been extended to gastric endoluminal surgery. Laboratory and clinical investigations have been initiated for various applications of this new form of surgery. Endoluminal gastric wall excision surgery is the most widely utilized and includes the removal of superficial gastric malignancies, benign gastric wall leiomyomas, and gastric polyps. Clinical experience has increased, and the initial results have been satisfactory. Pancreaticocystogastrostomy can be successfully performed using intraluminal surgery, but gastric wall bleeding and lack of fusion of the stomach to the cyst wall have complicated some cases. There are case reports of foreign body removal and intraluminal surgical procedures for patients with bleeding gastric ulcers. Of primary importance at this stage of development is the surgeon's familiarity with appropriate indications for gastric endoluminal surgery and the access devices currently available. Future considerations include the application of this approach to patients with gastroesophageal reflux disease, occult gastrointestinal bleeding, intractable bleeding from a duodenal ulcer, and multiinstitutional trials of gastric excision procedures.

Laparoscopic drainage of pancreatic pseudocysts

“…Mean surgical time was 2 h (range, 2-4). Median hospital stay was 14 days (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. One patient in the open group developed a small bowel obstruction secondary to an internal hernia that required reoperation, and one patient presented with a nosocomial pneumonia.…”

“…Using minimally invasive techniques, PPs can be managed by external or internal drainage [8,11,12,15,16]. Way et al [19], in a series of nine patients who underwent laparoscopic transgastric cystogastrostomy, reported a high cure rate with only one conversion.…”

“…Gagner and colleagues [8] reported six cystogastrostomies and one cystoduodenostomy with similar results. Martinez-Serna and Filipi [11] reported three patients with endo-organ cystogastrostomy with complete resolution after the surgical procedure in two of the three patients. Fernandez-Cruz et al [7] evaluated the feasibility and outcome of laparoscopic pancreatic surgery by performing distal pancreatectomy in five patients and transgastric drainage of PP in six patients, and they compared the results with those of a group of patients who underwent conventional open distal pancreatectomy.…”

Mucoadhesive film for anchoring assistive surgical instruments in endoscopic surgery: in vivo assessment of deployment and attachment

“…Diagnostic endoscopic retrograde cholangiopancreatography and sphincterotomy [2,3], biliary stent placement [4], and removal of gastric polyps [5] or small superficial gastric malignancies by snare cauterization [6] are some of the most effective endotherapeutic maneuvers currently performed in the stomach. However, the ability by these procedures to manipulate tissues is limited because of instrument limitations and space confinement [7].…”

Laparoscopic Intraluminal Surgery for Gastrointestinal Malignancies

“…The latest and probably one of the most important changes has been laparoscopic surgery, which began in 1986 with the advent of laparoscopic cholecystectomy and evolved dramatically to include almost every known abdominal surgical procedure. Today's trend toward increasingly more minimally invasive surgery has set the stage for endoluminal surgery, a discipline that is likely to become widespread in the field of digestive surgery in the upcoming years [1][2][3][4][5][6][7][8]. Starting with removing the organ that contains the disease, surgeons are moving toward a less invasive procedure that will result in less morbidity and improved patient outcomes [9][10][11][12][13].…”