Endoscopic full-thickness resection with laparoscopic assistance as hybrid NOTES for gastric submucosal tumor

Abe, Nobutsugu; Takeuchi, Hirohisa; Terabe, Masaki; Mori, Toshiyuki; Sugiyama, Masanori

doi:10.1007/s00464-008-0317-y

Cited by 104 publications

(77 citation statements)

References 14 publications

(20 reference statements)

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“…Pure EFTR, without laparoscopic procedures, has attracted attention as an extremely minimally invasive treatment. Abe et al first reported full-thickness resection for gastric cancer under laparoscopic and endoscopic guidance, named as laparoscopy-assisted endoscopic full-thickness resection (LAEFR) (11,12). The specific procedure is described as follows.…”

Section: Inverted Lecsmentioning

confidence: 99%

“…Published data are shown in Table 2 (9)(10)(11)(12)(13)(14)(15)(16)(21)(22)(23)(24). The tumor size was 7-60 mm, and the resected specimen size was 22.7-80 mm.…”

Section: Outcomes Of Classical Lecs and Lecs-related Proceduresmentioning

confidence: 99%

“…ESD enables en bloc complete resection of tumors, regardless of their location and size (6)(7)(8). With technological progress of ESD, endoscopic fullthickness resection (EFTR) techniques have been developed for gastric SETs (9)(10)(11)(12)(13)(14)(15)(16). These techniques are advantageous because a resection line can be determined more precisely using endoluminal endoscopy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

Niimi¹,

Ishibashi²,

Mitsui³

et al. 2017

Ann. Transl. Med.

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With technological progress of endoscopic submucosal dissection (ESD) in the last decade, several laparoscopic and endoscopic cooperative surgeries (LECS) for gastrointestinal tumor have recently been developed.LECS is definitely favorable to the minimization of surgical margin, which leads to functional and anatomical preservation of gastrointestinal tract. LECS for gastrointestinal tumor is mainly sorted by two categories: exposure procedures and non-exposure procedures between endoluminal and extraluminal spaces. Exposure procedures have the potential risk of gastric contents or tumor cells spilling out over the abdominal cavity, because the stomach wall has to be perforated intentionally during the procedure. In order to avoid the potential these risks, nonexposure procedures have been developed. Currently, the LECS concept has rapidly permeated for treatment of gastrointestinal tumor due to its certainty and safety, although there is still room for improvement to lessen its technical difficulty. This review describes the current LECS for gastrointestinal tumor based on the several articles.

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Section: Inverted Lecsmentioning

confidence: 99%

“…Published data are shown in Table 2 (9)(10)(11)(12)(13)(14)(15)(16)(21)(22)(23)(24). The tumor size was 7-60 mm, and the resected specimen size was 22.7-80 mm.…”

Section: Outcomes Of Classical Lecs and Lecs-related Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

Niimi¹,

Ishibashi²,

Mitsui³

et al. 2017

Ann. Transl. Med.

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“…Endoscopic full-thickness resection (EFTR) with or without laparoscopic assistance is a promising method to minimize a resection area according to a lesion size [1][2][3][4]. Because a demarcation line of the lesion can be clearly visualized from the inside of the lumen by using endoscopy, the resection area can be optimally determined via this technique.…”

Section: Introductionmentioning

confidence: 99%

First case of non-exposed endoscopic wall-inversion surgery with sentinel node basin dissection for early gastric cancer

et al. 2014

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Introduction Non-exposed endoscopic wall-inversion surgery (NEWS) is a novel technique of endoscopic fullthickness resection without transluminal access mainly designed to treat gastric cancer. Here, we report a successful case of NEWS with sentinel node basin dissection (SNBD) for early gastric cancer (EGC) with the risk of lymph node metastasis. Patient and methods A 55-year-old female patient with a 2-cm, diffuse-type intramucosal EGC with ulceration was referred to our hospital for a less invasive gastrectomy based on sentinel node navigation surgery. After obtaining informed consent, NEWS with SNBD was applied. After placing mucosal markings, indocyanine green solution was injected endoscopically into the submucosa around the lesion to examine sentinel nodes (SNs). The SN basin (the area of the left gastric artery), including three stained SNs(#3), was dissected, and an intraoperative pathological diagnosis confirmed that no metastasis had occurred. Subsequently, NEWS was performed for the primary lesion. Serosal markings were placed laparoscopically, submucosal injection was added endoscopically, and circumferential sero-muscular incision and suturing were performed laparoscopically, with the lesion inverted toward the inside of the stomach. Finally, the circumferential mucosal incision was performed, and the lesion was retrieved perorally. Results The operation was finished in 270 min without complications. The patient was uneventfully discharged 10 days after the procedure. The final pathological diagnosis was coincident with the pre-and intraoperative assessment. Conclusions We demonstrated the feasibility and safety of NEWS with SNBD with a favorable result. This surgical concept is expected to become a promising, minimally invasive, function-preserving surgery to cure cases of EGC that are possibly node-positive.

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“…Endoscopic full-thickness resection (EFTR) has been invented as a minimally invasive endoluminal surgery for gastrointestinal tumors [1][2][3]. The important characteristic of EFTR is that the margin of the tumor can be definitely checked from the inside with a flexible endoscope and the full layer of the tract is resected, so the resection size can be made smaller and a lesion that has penetrated into the deeper layer of the wall can be resected.…”

Section: Introductionmentioning

confidence: 99%

New method of endoscopic full-thickness resection: a pilot study of non-exposed endoscopic wall-inversion surgery in an ex vivo porcine model

et al. 2011

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The indications for endoscopic full-thickness resection (EFTR) are limited because transmural communication during the entire procedure, causing tumor dissemination into the abdominal space, is inevitable. We invented a new method of EFTR without transmural communication, and explored its feasibility in an ex vivo porcine model. Three explanted porcine stomachs were used. First, markings around a model lesion were made with a flexible endoscope, and 0.9% normal saline with indigocarmine was injected into the submucosa around the markings. Second, a circumferential sero-muscular incision was made from the outside with an electrocautery knife, guided by the color of the submucosal injection and intragastric navigation with the endoscope. Third, the muscle layer was linearly sutured with the lesion inverted into the inside. Finally, a circumferential muco-submucosal incision was made with an electrocautery knife employed with the endoscope. The method was performed for 3 lesions (1 anterior wall, 1 lesser curve, and 1 posterior wall of the gastric body), and all lesions were successfully resected in en-bloc fashion. The mean size of the resected specimen was 4.5 cm in diameter. Neither perforation nor apparent air leakage was seen during or after the resection. Non-exposed endoscopic wall-inversion surgery (NEWS) is thought to be effective as a minimally invasive, and minimal-size endoluminal surgery for gastric submucosal tumors with or without ulceration, or even node-negative early gastric cancer that is difficult to resect by endoscopic submucosal dissection.

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Endoscopic full-thickness resection with laparoscopic assistance as hybrid NOTES for gastric submucosal tumor

Cited by 104 publications

References 14 publications

Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

First case of non-exposed endoscopic wall-inversion surgery with sentinel node basin dissection for early gastric cancer

New method of endoscopic full-thickness resection: a pilot study of non-exposed endoscopic wall-inversion surgery in an ex vivo porcine model

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