CURRENT STATUS AND FUTURE PERSPECTIVE OF LAPAROSCOPIC AND ENDOSCOPIC COOPERATIVE SURGERY

Abstract

Laparoscopic and endoscopic cooperative surgery (LECS), which provides safe, secure, and optimally-designed full-thickness resection, has been covered by insurance in Japan since 2014, and has been accepted as a less-invasive local resection technique mainly for gastric submucosal tumors both domestically and internationally. After introducing an exposure technique (classical LECS), non-exposure techniques, e.g., combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) and non-exposed endoscopic wall-inversion surgery (NEWS), have been developed, which enable us to choose the optimal method according to characteristics of the target lesions. Currently, leading hospitals are trying to expand the indications for LECS to gastric cancers and tumors in other organs, and further to fuse it with sentinel node navigation surgery. Expansion of the indications for LECS is expected in the future.