Systematic Reviews
Copyright ©The Author(s) 2015.
World J Gastroenterol. Nov 21, 2015; 21(43): 12482-12497
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12482
Table 4 Advantages and disadvantages of the various cooperative laparoscopic endoscopic techniques
Technique nameProsCons
LAERMinimally invasive approachSuitable for small lesions with intraluminal expansion
Monitoring and backup from the laparoscopic team in case of accidental perforationRequires advanced endoscopy skills
EAWRNo requirement of advanced laparoscopic or endoscopic skillsLeaves larger wall defects compared to other methods
Good entry level for teams starting cooperative techniquesRisk of gastric deformation or stenosis from stapling
EATRFavorable access to lesions ≤ 2 cm, situated high on the posterior wall or lesser curvature without mobilizing the stomachRequires gastrotomy closure
May lead to spillage with peritoneal contamination and dissemination
LIGSSimilar to EATRRisk of gastric deformation or stenosis from stapling
ELISSame as EATRSame as LIGS
Difficulty in orienting the stapler under endoscopic view
Single port LIGSLess invasive than the classic LIGSRequires previous experience in single port laparoscopy
The gastrotomy can be closed through the single port incisionMore difficult than EATR and LIGS
LECSCombines the advantages of both endoscopy and laparoscopy. No restriction in the size or location of the tumorRequires advanced endoscopy and laparoscopy skills. More adapted in high volume centers
Risk of spillage and contamination
Not adapted for early gastric cancer
Inverted LECSDiminishes the risk of peritoneal cancer disseminationNot adapted for early gastric cancer
LAEFRMinimal invasive endoscopic resectionRequires advanced endoscopy skills in dissection techniques and closure of wide wall defects with macro-clips or suturing devices
The procedure is facilitated by the laparoscopic view and exposure
Clean-NETDiminishes the risk of peritoneal dissemination of gastric cancerLimited literature
Requires special training
Risk of mucosal tear with cancer cell dissemination
NEWSDiminishes the risk of peritoneal dissemination of early gastric cancerLimited literature. Requires special training