| International Session（Workshop）3(JGES・JSGE・JSGS) |
| Sat. November 2nd 9:00 - 12:00 Room 4: Portopia Hotel South Wing Portopia Hall |
| Endoscopic Management of Extremely Challenging Cases; Resection and Suturing | |||
| Fatih Aslan | |||
| Koc University Hospital | |||
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| Endoscopic submucosal dissection (ESD), originating from Japan, is a minimally invasive organ-sparing technique used for esophageal, colonic, and rectal cancers, following its proven efficacy in early-stage gastric cancers. With improved resection techniques and completion of the learning curve, adverse events have significantly decreased, and success rates have increased. However, ESD remains challenging for lesions in the duodenum, colonic flexures, ileum, or those with large size, severe fibrosis, or complex shapes. Gravitational issues, equipment use in certain locations, and stricture risk are additional disadvantages that may deter endoscopists. The advancement in hemoclip, endoloop, and suturing techniques over the past 20 years has enabled the management of adverse events without surgery, resulting in safer endoscopic resections. New closing methods now allow "en bloc" and complete resections of subepithelial lesions by deliberately crossing beyond the gastrointestinal wall. Long-term results of endoscopic resections and technological advances have made nonsurgical removal of previously inoperable lesions possible. Integrating suturing technology from laparoscopic-robotic surgery into endoscopy has provided numerous advantages and boosted endoscopist confidence. We believe that, along with artificial intelligence, adapting certain surgical systems into endoscopy will make many treatments possible. Despite the advancements, performing such endoscopic resections remains challenging but not impossible under current facilities. |
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Index Term 1: ESD Index Term 2: suturing |
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