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Adam Whitley 1 Article
Non-Exposure Endoscopic-Laparoscopic Cooperative Surgery for Stomach Tumors: First Experience from the Czech Republic
Jan Hajer, Lukáš Havlůj, Adam Whitley, Robert Gürlich
Clin Endosc 2018;51(2):167-173.   Published online January 4, 2018
DOI: https://doi.org/10.5946/ce.2017.076
AbstractAbstract PDFPubReaderePub
Background
/Aims: The aim of this study was to investigate the use of non-exposure endoscopic wall-inversion surgery (NEWS) and the combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) in gastric tumors.
Methods
We reviewed all cases of NEWS and CLEAN-NET performed in the department of surgery of the Royal Vinohrady Teaching Hospital.
Results
Our department performed 12 gastric tumor resections (NEWS, n=10 and CLEAN-NET, n=2) between March 2016 and February 2017. The cases chosen for these resections included predominantly submucosal tumors with no signs of dissemination or local invasion and early gastric carcinomas (T1SM1 and T1M), where tumor location made it impossible to use endoscopic submucosal dissection. R0 resection margins were confirmed in all the cases.
Conclusions
NEWS and CLEAN-NET allow en bloc non-exposed full-thickness gastric wall resection in a way that uses a “close first, cut later” approach to prevent seeding of the peritoneal cavity with tumor cells. These mini-invasive techniques combine laparoscopic and endoscopic techniques, and preserve the full function of the stomach.

Citations

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  • Comparison of Nonexposed Endoscopic Wall-Inversion Surgery with Endoscopic-Navigated Laparoscopic Wedge Resection for Gastric Submucosal Tumours: Results of a Two-Centre Study
    Jan Hajer, Lukáš Havlůj, Petr Kocián, Günther Klimbacher, Andreas Shamiyeh, Robert Gürlich, Adam Whitley
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