Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2015; 7(11): 326-334
Published online Nov 27, 2015. doi: 10.4240/wjgs.v7.i11.326
Endoscopic surgery - exploring the modalities
Daniel Jin Keat Lee, Kok-Yang Tan
Daniel Jin Keat Lee, Kok-Yang Tan, Department of Surgery, Khoo Teck Puat Hospital, Singapore 768828, Singapore
Author contributions: Lee DJK performed the majority of the research around this topic, wrote the manuscript and obtained figures for the article; Tan KY designed the article framework and contributed to the editing of the manuscript.
Conflict-of-interest statement: The authors report no conflict of interest. The authors are responsible for the content and writing of the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Kok-Yang Tan, Clinical Associate Professor, Clinical Director of Geriatric Surgery Service, Head and Senior Consultant of Department of Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore.
Telephone: +65-66023207 Fax: +65-66023648
Received: April 19, 2015
Peer-review started: April 21, 2015
First decision: August 19, 2015
Revised: September 14, 2015
Accepted: October 1, 2015
Article in press: October 8, 2015
Published online: November 27, 2015

The adoption of endoscopic surgery continues to expand in clinical situations with the recent natural orifice transluminal endoscopic surgery technique enabling abdominal organ resection to be performed without necessitating any skin incision. In recent years, the development of numerous devices and platforms have allowed for such procedures to be carried out in a safer and more efficient manner, and in some ways to better simulate triangulation and surgical tasks (e.g., suturing and dissection). Furthermore, new novel techniques such as submucosal tunneling, endoscopic full-thickness resection and hybrid endo-laparoscopic approaches have further widened its use in more advanced diseases. Nevertheless, many of these new innovations are still at their pre-clinical stage. This review focuses on the various innovations in endoscopic surgery, with emphasis on devices and techniques that are currently in human use.

Keywords: Transanal total mesorectal excision, Natural orifice transluminal endoscopic surgery, Endoscopic surgery, Submucosal tunneling technique, Endoscopic submucosal dissection, Endoscopic full-thickness resection, Endo-laparoscopic

Core tip: This article is a comprehensive review of endoscopic surgery. It analyses the different types of endosurgery from endoscopic submucosal dissection, endoscopic full-thickness resection and natural orifice transluminal endoscopic surgery. This article highlights the relevant topics and recent advances in this area. In addition all the latest procedural devises such as the master and slave transluminal endoscopic robot endoscopic robot, multitasking endoscopes and other examples are described. Finally a clear and comprehensive review of the latest human clinical trials and their outcomes are outlined. Hence overall, readers will have a full understanding of endosurgery, the currently available as well as upcoming technology and their safety profiles.