Laparoscopic Combined with Endoscopic Management of Gastrointestinal Stromal Tumors

Laparoscopic and endoscopic cooperative surgery has emerged as a minimally invasive surgical technique for GIST in recent years. In the past, when laparoscopy was performed alone, it was not easy to detect smaller lesions (tumor diameter <2 cm) due to the lack of fine tactile sensation [1]. In addition, due to the limitation of laparoscopic instruments, it is more difficult to assess the posterior wall of the gastroduodenum and intraluminal tumors during exploration, which easily leads to the omission of lesion resection and procedure conversion to laparotomy [2]. In this case, intraoperative gastroscopy to locate the lesion was particularly necessary to ensure the smooth progress of laparoscopic surgery. In addition, as GIST lesions found under gastroscopy generally originate from the muscularis propria, the risks of treatment using gastroscopy alone are greater, and the operation time is increased. The use of laparoscopy can assist endoscopic procedures, through timely detection and management of complications arising from endoscopic resection, therefore increasing surgical safety and efficiency [3]. Laparoscopic and endoscopic cooperative surgery combines the advantages of laparoscopy and endoscopy, counteracts the disadvantages of laparoscopy or endoscopy alone, and further expands the scope of application for minimally invasive surgical techniques.