There is a significant need for a safe and easy technique for endoluminal endoscopic
resection of gastrointestinal lesions, but such procedures are usually restricted
to resection of the mucosal layer in order to preserve the integrity of the wall of
the gastrointestinal tract. We present two patients, one with early cancer and one
with a carcinoid tumor, who were treated by endoscopic full-thickness resection. We
used a stapling device, consisting of a flexible shaft, which was positioned intraluminally,
and a remote control. After pilot investigations in pigs and in human anatomical preparations,
we performed a full-thickness resection of the gastric wall in these patients, using
the flexible stapling device under gastroscopic control. Gastric wall specimens up
to 4 cm × 4 cm in size were resected with the use of two to three stapler magazines.
Both procedures followed an uneventful course and the patients made an uncomplicated
recovery. Further studies are necessary to test the applicability of the technique
in the management of other gastric neoplastic lesions.
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in press
G. F. B. A. Kähler, M. D.
Sektion Endoskopie und Sonographie
Chirurgische Universitätsklinik Mannheim · Theodor-Kutzer-Ufer 1 - 3 · 68167 Mannheim
· Germany
Fax: +49-383-3385 ·
Email: georg.kaehler@chir.ma.uni-heidelberg.de
