Developments in flexible endoscopic surgery: a review

Flexible endoscopy is increasingly developing into a therapeutic instead of a purely diagnostic discipline. Improved visualization makes early lesions easily detectable and allows us to decide ad hoc on the required treatment. Deep enteroscopy allows the exploration of even the small bowel - for lon...

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Bibliographic Details
Published in:Clinical and experimental gastroenterology 2015-01, Vol.8 (default), p.31-42
Main Authors: Feussner, Hubertus, Becker, Valentin, Bauer, Margit, Kranzfelder, Michael, Schirren, Rebekka, Lüth, Tim, Meining, Alexander, Wilhelm, Dirk
Format: Article
Language:English
Subjects:
Cancer
Clinical trials
Dissection
Endoscopy
Esophagus
Gastroenterology
Gastroesophageal reflux
Health aspects
Hydrogels
Laparoscopy
Lasers
Medical equipment
Medical research
Microscopy
Review
Small intestine
Surgery
Tumors
Working groups
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Summary:Flexible endoscopy is increasingly developing into a therapeutic instead of a purely diagnostic discipline. Improved visualization makes early lesions easily detectable and allows us to decide ad hoc on the required treatment. Deep enteroscopy allows the exploration of even the small bowel - for long a "white spot" for gastrointestinal endoscopy - and to perform direct treatment. Endoscopic submucosal dissection is a considerable step forward in oncologically correct endoscopic treatment of (early) malignant lesions. Though still technically challenging, it is increasingly facilitated by new manipulation techniques and tools that are being steadily optimized. Closure of wall defects and hemostasis could be improved significantly. Even the anatomy beyond the gastrointestinal wall is being explored by the therapeutic use of endoluminal ultrasound. Endosonographic-guided surgery is not only a suitable fallback solution if conventional endoscopic retrograde cholangiopancreatography fails, but even makes necrosectomy procedures, abscess drainage, and neurolysis feasible for the endoscopist. Newly developed endoscopic approaches aim at formerly distinctive surgical domains like gastroesophageal reflux disease, appendicitis, and cholecystitis. Combined endoscopic/laparoscopic interventional techniques could become the harbingers of natural orifice transluminal endoscopic surgery, whereas pure natural orifice transluminal endoscopic surgery is currently still in its beginnings.
ISSN:1178-7023
1178-7023
DOI:10.2147/CEG.S46584