Endoscopic full thickness resection: A surgeon's perspective

Innovations in surgical instrumentation and methods are enabling safe and effective minimally invasive options for treatment of many diseases. Similarly, technologic advances in endoscopy are offering assistive devices and techniques to enable more aggressive, yet safe, endoscopic therapies. Endoscopic mucosal resection and submucosal dissection are quickly becoming adopted to offer appropriate patients the least invasive treatment, that is, treatment without surgical scars or approaches. On the horizon at the time of this writing is endoscopic full-thickness resection, which if proven safe has potential to offer the same advantages to a wider variety of pathology. This chapter will focus on a surgeon's perspective of gastrointestinal disease, traditional surgical treatments, and possibilities for these new endoscopic techniques.