Ntourakis D, Mavrogenis G. Cooperative laparoscopic endoscopic and hybrid laparoscopic surgery for upper gastrointestinal tumors: Current status. World J Gastroenterol 2015; 21(43): 12482-12497 [PMID: 26604655 DOI: 10.3748/wjg.v21.i43.12482]
Corresponding Author of This Article
Dimitrios Ntourakis, MD, PhD, Third Department of Surgery, University of Athens Faculty of Medicine, Attikon University Hospital, Rimini 1, T.K. 12463 Chaidari, Athens, Greece. dntourakis@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
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Table 4 Advantages and disadvantages of the various cooperative laparoscopic endoscopic techniques
Technique name
Pros
Cons
LAER
Minimally invasive approach
Suitable for small lesions with intraluminal expansion
Monitoring and backup from the laparoscopic team in case of accidental perforation
Requires advanced endoscopy skills
EAWR
No requirement of advanced laparoscopic or endoscopic skills
Leaves larger wall defects compared to other methods
Good entry level for teams starting cooperative techniques
Risk of gastric deformation or stenosis from stapling
EATR
Favorable access to lesions ≤ 2 cm, situated high on the posterior wall or lesser curvature without mobilizing the stomach
Requires gastrotomy closure
May lead to spillage with peritoneal contamination and dissemination
LIGS
Similar to EATR
Risk of gastric deformation or stenosis from stapling
ELIS
Same as EATR
Same as LIGS
Difficulty in orienting the stapler under endoscopic view
Single port LIGS
Less invasive than the classic LIGS
Requires previous experience in single port laparoscopy
The gastrotomy can be closed through the single port incision
More difficult than EATR and LIGS
LECS
Combines the advantages of both endoscopy and laparoscopy. No restriction in the size or location of the tumor
Requires advanced endoscopy and laparoscopy skills. More adapted in high volume centers
Risk of spillage and contamination
Not adapted for early gastric cancer
Inverted LECS
Diminishes the risk of peritoneal cancer dissemination
Not adapted for early gastric cancer
LAEFR
Minimal invasive endoscopic resection
Requires 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-NET
Diminishes the risk of peritoneal dissemination of gastric cancer
Limited literature
Requires special training
Risk of mucosal tear with cancer cell dissemination
NEWS
Diminishes the risk of peritoneal dissemination of early gastric cancer
Limited literature. Requires special training
Citation: Ntourakis D, Mavrogenis G. Cooperative laparoscopic endoscopic and hybrid laparoscopic surgery for upper gastrointestinal tumors: Current status. World J Gastroenterol 2015; 21(43): 12482-12497