Submucosal endoscopy

Abstract

Submucosal surgery has emerged over the past decade as a safe and effective treatment for both benign and malignant diseases of the gastrointestinal tract. Endoscopic creation of a submucosal tunnel or flap allows for access to various muscular structures as well as en bloc resection of muscle- and mucosa-based lesions. Per oral endoscopic myotomy for the treatment of achalasia is supported by robust data on safety and short-term outcomes with promising long-term outcomes data. Per oral pyloromyotomy uses the experience gained from per oral endoscopic myotomy in the treatment of gastroparesis, a chronic disease that often proves challenging to effectively treat. A submucosal tunnel or dissection is created to remove tumors of the submucosa in addition to removing early stage cancers of the gastrointestinal tract, providing an alternative to the higher morbidity surgical approaches to resection. Submucosal surgery is an innovative approach to the treatment of a variety of gastrointestinal diseases traditionally treated by open and laparoscopic surgical techniques.