A clinical practice for gastrointestinal tumors by collaboration of endoscopist and surgeon

Abstract

In our institution, treatment plans for gastrointestinal tumors are decided on a weekly conference with staffs concerned in departments of gastroenterology, endoscopy, surgery and radiology. Furthermore, collaborative surgery by endoscopists and surgeons is also clinically performed as laparoscopic and endoscopic cooperative surgery (LECS) . Sentinel node navigation surgery (SNNS) for cT1N0M0 early gastric cancer is a typical case of LECS. In SNNS, minimally invasive surgery can be applied to SN-negative cases. Particularly, we conduct non-exposed endoscopic wall-inversion surgery in cases which have localized SNs and lymphatic flows. The collaboration is effective not only for diagnosis and treatment but also for development of new technique. Endoscopic hand suturing, which enables to suture the mucosal defect using curved needle and thread in the stomach, has been developed by the inspiration of laparoscopic hand suturing performed. Collaboration with different specialties is important for a clinical practice as well as development of novel treatments.