2009 Program and Abstracts: Natural Orifice Surgery for Early Stage Esophageal Malignancy: Proof of Concept
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Natural Orifice Surgery for Early Stage Esophageal Malignancy: Proof of Concept
Bart P. Witteman*1, Andres Gelrud2, George M. Eid3, Alejandro Nieponice4, Stephen F. Badylak4,3, Blair a. Jobe1
1The Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, PA; 2Division of Gastroenterology, Hepatology & Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA; 3Division of General Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA; 4McGowan Institute for Regenerative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
BackgroundEndoscopic therapies were introduced for treatment of superficial cancer with the goal of esophageal preservation. These techniques have limitations based in sampling errors and histologic accuracy.ObjectiveTo determine feasibility of transoral endoscopic resection of the esophageal mucosal-submucosal complex (MSC) in an animal model.MethodsUsing flexible endoscopic surgery, a sleeve of MSC is resected over the entire esophageal length.Conclusion This video demonstrates proof of concept for transoral endoscopic esophagectomy. When stricture formation is controlled with extra cellular matrix substitution, this technique may be an alternative to traditional esophagectomy.
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