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PTH-142 Laparoscopic assisted surgery (Intraluminal Surgery): gastroduodenal lesions resecction and laparoscopic monitored colonoscopic polypectomy (LMCP). texas endosurgery institute experience
  1. MA Hernandez1,
  2. ME Franklin2,
  3. JL Glass2
  1. 1Minimally Invasive Surgery
  2. 2Texas Endosurgery Institute, San Antonio, USA

Abstract

Introduction Intraluminal surgery began with the advent of endoscopy. Laparoscopic assisted intraluminal technique is a novel alternative to open or laparoscopic surgery. Endoscopic lesions resection is limited for the view of endoscopic, insufficient number of instrument channels, and the inability to obtain adequate margins without risking perforation. The aim of this study is to demonstrate the feasibility and safety of the use of a hybrid technique.

Method From May 1990 to February 2015, all patients undergoing LMCP and early gastric and duodenal lesions were analysed and prospectively followed with control endoscopy studies, 6 months, 1 year and every year there after. Operations were performed laparoscopically in conjunction with endoscopy.

Results 24 patients were undergoing to gastro-duodenal lesions resection. 10 early gastric cancer (Stage I), 6 wedge of carcinoid tumour, 4 duodenal adenocarcinoma and 4 malignant polyps at the gastro-oesophageal junction. 320 colonic polyps were removed in 270 patients. 229 polyps were adenomas (114 tubular-villus, 58 villus, and 57 tubular), 66 were carcinomas (40 mod diff, 26 highly diff), 25 with other histologic type.

Conclusion Long-term follow-up demonstrated that intraluminal surgery for early gastric and duodenal cancer is a feasible and safe alternative. Malignant lesions identified during LMCP can be treated laparoscopically during the same operation.

Disclosure of interest None Declared.

References

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  4. Franklin ME Jr, Diaz-E JA, Abrego D, et al. Laparoscopicassisted colonoscopic polypectomy: the Texas Endosurgery Institute experience. Dis Colon Rectum. 2000;43:1246–1249

  5. Franklin ME, Abrego D, Balli J. Combined laparoscopic and flexible endoscopic techniques in the management of malignant gastrointestinal lesions. Semin Surg Oncol. 1998;15:183–188

  6. Franklin ME Jr, Leyva-Alvizo A, Abrego-Medina D, et al. Laparoscopically monitored colonoscopic polypectomy: an established form of endoluminal therapy for colorectal polyps. Surg Endosc. 2007;21:1650–1653

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