Endoluminal surgery

Excerpt

Since 1987, minimal access surgery via the laparoscope has become the standard of care for most abdominal procedures. In the past five years, laparoscopic surgical techniques have been further refined and large series have been published with excellent 5-15 year results. These data have demonstrated the benefits of minimal access surgery in decreasing morbidity, mortality, length of hospitalization, and improving cosmetic results. Within the past 2-3 years, there have been several articles published with 1-2 year results using flexible endoscopic techniques to treat GERD, [1-6] and a few other articles have discussed the full thickness excision of gastric and colonic tumors along with closure of the visceral defect. Endoluminal stenting has been used with confirmed efficacy in cardiovascular vascular disease, obstructing colonic neoplasms avoiding the need for proximal colostomy/diversion [7, 8], malignant gastric outlet obstruction [9], and bronchial occlusion [10]. Some of the flexible endoscopic endoluminal procedures have required endoscopic suturing, clipping of tissue, and the use of a flexible endoscopic EEA and GIA staplers. Of some concern to us, as editors of Surgical Endoscopy, is the realization that these procedures have been and are currently largely performed by gastroenterologists, and only a few have thus far been reported in the surgical literature. …