Organ-sparing and functionally-sparing hybrid endoscopic surgeries in gastrointestinal tract surgery

Hamartoma polyps are benign epithelial The application of laparoscopic-endoscopic hybrid techniques in the treatment of patients with non-epithelial tumors of the upper gastrointestinal tract, early gastric cancer, and cholelithiasis complicated by choledocholithiasis and stricture of the terminal part of the common bile duct allows, through the combination of endoscopic and laparoscopic manipulation capabilities, to achieve optimal functional-sparing and organ-preserving results. At the same time, this approach helps to minimize the risks of postoperative complications and functional disorders, as well as to reduce the length of hospital stay. It should be noted that the performance of hybrid surgeries is only possible in specialized centers with a high level of specialists and the necessary equipment, as well as with developed interaction between endoscopic and laparoscopic teams.

hybrid surgeries, laparoscopic-endoscopic access, organ-preserving nature, functionally sparing principle, early gastric cancer, non-epithelial tumor, cholelithiasis

1. Ntourakis D., Mavrogenis G. Cooperative laparoscopic endoscopic and hybrid laparoscopic surgery for upper gastrointestinal tumors: Current status. World J Gastroenterol. 2015 Nov 21;21(43):12482-97. doi: 10.3748/wjg.v21.i43.12482.

2. Wu R., Zhen-Ling J. I. Laparoscopic-Endoscopic Cooperative Surgery for Gastric Gastrointestinal Stromal Tumors. Clin Surg. 2016;(1):1234. doi: 10.1007/s10346-018-1046-5.

3. Waseda Y., Doyama H., Inaki N., Nakanishi H., Yoshida N., Tsuji S., Takemura K., Yamada S., Okada T. Does laparoscopic and endoscopic cooperative surgery for gastric submucosal tumors preserve residual gastric motility? Results of a retrospective single-center study. PLoS One. 2014 Jun 26;9(6): e101337. doi: 10.1371/journal.pone.0101337.

4. Hamura R., Koyama T., Kawamura M., Kawamura T., Nakamura M., Yanaga K. Gastric calcifying fibrous tumor suspected to be complicated with immunoglobulin G4-related disease treated by laparoscopy and endoscopy cooperative surgery: a case report. Surg Case Rep. 2019 Oct 22;5(1):150. doi: 10.1186/s40792-019-0714-6.

5. Hajer J., Havlůj L., Whitley A., Gürlich R. Non-Exposure Endoscopic-Laparoscopic Cooperative Surgery for Stomach Tumors: First Experience from the Czech Republic. Clin Endosc. 2018 Mar;51(2):167-173. doi: 10.5946/ce.2017.076.

6. Hiki N., Nunobe S. Laparoscopic endoscopic cooperative surgery (LECS) for the gastrointestinal tract: Updated indications. Ann Gastroenterol Surg. 2019 Feb 19;3(3):239-246. doi: 10.1002/ags3.12238.

7. Aisu Y., Yasukawa D., Kimura Y., Hori T. Laparoscopic and endoscopic cooperative surgery for gastric tumors: Perspective for actual practice and oncological benefits. World J Gastrointest Oncol. 2018 Nov 15;10(11):381-397. doi: 10.4251/wjgo.v10.i11.381.

8. Wang H., Cao L., Zheng K., Zhao Y. Laparoscopic endoscopic co operative surgery for gastrointestinal stromal tumors. Surg Laparosc Endosc Percutan Tech. 2018 Dec;28(6):354-358. doi: 10.1097/SLE.0000000000000591.

9. Starkov Yu.G., Solodinina E. N., Dzhantukhanova S. V., Vyborniy M. I., Lukich K. V., Zamolodchikov R. D. Classification of non-epithelial tumors of the upper gastrointestinal tract for the choice of surgical intervention. Oncology bulletin of the Volga region. 2017;5 (32): 45-50. (In Russ.)@@ Старков Ю. Г., Солодинина Е. Н., Джантуханова С. В., Выборный М. И., Лукич К. В., Замолодчиков Р. Д. Классификация неэпителиальных опухолей верхних отделов желудочно-кишечного тракта для выбора способа оперативного вмешательства. Поволжский онкологический вестник. 2017;5(32):45-50.

10. Dzhantukhanova SV, Starkov YuG, Zamolodchikov RD, Zvereva AA, Kontorshchikov PK. The techniques of hybrid laparo-endoscopic resections for non-epithelial gastric tumors. Endoscopic Surgery = Endoskopicheskaya khirurgiya. 2021;27(4):47-60. (In Russ.) doi: 10.17116/endoskop20212704147.@@ Джантуханова С. В., Старков Ю. Г., Замолодчиков Р. Д., Зверева А. А., Конторщиков П. К. Гибридные лапароэндоскопические операции при неэпителиальных опухолях желудка. Эндоскопическая хирургия. 2021;27(4):47-60. doi: 10.17116/endoskop20212704147.

11. Li H., Zhao L. L., Zhang X. C., Liu D. X., Wang G. Y., Huo Z. B., Chen S. B.Combination of endoscopic submucosal dissection and laparoscopic sentinel lymph node dissection in early mucinous gastric cancer: Role of lymph node metastasis. World J Clin Cases. 2020 Aug 26;8(16):3474-3482. doi: 10.12998/wjcc.v8.i16.3474.

12. Kim S. G., Eom B. W., Yoon H. M., Kim C. G., Kook M. C., Kim Y. W., Ryu K. W. Recent updates and current issues of sentinel node navigation surgery for early gastric cancer. Chin J Cancer Res. 2021 Apr 30;33(2):142-149. doi: 10.21147/j.issn.1000-9604.2021.02.02.

13. Tan C., Ocampo O., Ong R., Tan K. S.Comparison of one stage laparoscopic cholecystectomy combined with intra-operative endoscopic sphincterotomy versus two-stage pre-operative endoscopic sphincterotomy followed by laparoscopic cholecystectomy for the management of pre-operatively diagnosed patients with common bile duct stones: a meta-analysis. Surg Endosc. 2018;32:770-778. doi: 10.1007/s00464-017-5739-y.

14. Starkov Yu.G., Dzhantukhanova S. V., Zamolodchikov R. D., Zvereva A. A. Hybrid laparo-endoscopic operation in a patient with complicated choledocholithiasis. Endoscopic Surgery = Endoskopicheskaya khirurgiya. 2022;28(3):47-52. (In Russ.). doi: 10.17116/endoskop20222803147.@@ Старков Ю. Г., Джантуханова С. В., Замолодчиков Р. Д., Зверева А. А. Гибридная лапароэндоскопическая операция у пациентки со сложным холедохолитиазом. Эндоскопическая хирургия. 2022;28(3):47-52. doi: 10.17116/endoskop20222803147.

15. Starkov Yu.G., Vagapov A. I., Zamolodchikov R. D., Dzhantukhanova S. V., Arabova P. Sh. Laparoendoscopic hybrid treatment of a patient with choledocholithiasis, cholecystitis and large duodenal diverticula. Pirogov Russian Journal of Surgery. 2025;(1):6267. (In Russ.) doi: 10.17116/hirurgia202501162.@@ Старков Ю. Г., Вагапов А. И., Замолодчиков Р. Д., Джантуханова С. В., Арабова П. Ш. Лапароэндоскопический гибридный метод лечения пациента с холедохолитиазом, холециститом и крупными дивертикулами двенадцатиперстной кишки. Хирургия. Журнал им. Н. И. Пирогова. 2025;(1):6267. doi: 10.17116/hirurgia202501162.

16. Starkov Ju.G., Solodinina E. N., Novozhilova A. V. [Submucosal neoplasms of the gastrointestinal tract in endoscopic practice]. Hirurgija. Zhurnal im. N. I. Pirogova. 2010;(2):51 59. (In Russ.)@@ Старков Ю. Г., Солодинина Е. Н., Новожилова А. В. Подслизистые новообразования желудочно-кишечного тракта в эндоскопической практике. Хирургия. Журнал им. Н. И. Пирогова. 2010;(2):5159.

17. Shim J. H., Lee H. H., Yoo H. M., Jeon H. M., Park C. H., Kim J. G., Song K. Y.Intragastric approach for submucosal tumors located near the Z-line: a hybrid laparoscopic and endoscopic technique. J Surg Oncol. 2011;104:312-315. doi: 10.1002/jso.21934.

18. Kondo S., Isayama H., Akahane M. et al. Detection of common bile duct stones: comparison between endoscopic ultrasonography, magnetic resonance cholangiography, and helical-computed-tomographic cholangiography. Eur J Radiol. 2005 May;54(2):271-5. doi: 10.1016/j.ejrad.2004.07.007.

19. Dasari B. V., Tan C. J., Gurusamy K. S. et al. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev. 2013;12: CD003327. doi: 10.1002/14651858.CD003327.

20. Wang B., Guo Z., Liu Z., Wang Y., Si Y., Zhu Y., Jin M. Preoperative versus intraoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones: system review and metaanalysis. Surgical Endoscopy. 2013;27(7):2454-2465. doi: 10.1007/s00464-012-2757-7.

21. Ansaloni L., Pisano M., Coccolini F., Peitzmann A. B., Fingerhut A., Catena F., Bendinelli C. 2016 WSES guidelines on acute calculous cholecystitis. World Journal of Emergency Surgery. 2016;11(1):25. doi: 10.1186/s13017-016-0082-5.

22. Starkov Yu.G., Shishin K. V., Solodinina E. N., Domarev L. V., Kobesova T. A. Antegrade papillosphincterotomy during laparoscopic cholecystectomy. Khirurgiya. Zhurnal im. N. I. Pirogova. 2003;3:14-17. (In Russ.)@@ Старков Ю. Г., Шишин К. В., Солодинина Е. Н., Домарев Л. В., Кобесова Т. А. Антеградная папиллосфинктеротомия во время лапароскопической холецистэктомии. Хирургия. Журнал им. Н. И. Пирогова. 2003;3:14-17.

23. Dzhantukhanova S., Avetisyan L. G., Badakhova A., Starkov Y., Glotov A. Hybrid laparo-endoscopic access: New approach to surgical treatment for giant fibrovascular polyp of esophagus: A case report and review of literature. World J Gastrointest Endosc. 2023 Nov 16;15(11):666-675. doi: 10.4253/wjge.v15.i11.666.

24. Dzhantukhanova S., Starkov Y., Solodinina E., Zamolodchikov R. The smart approach to surgical treatment of submucosal tumors based on preoperative EUS-typing. Ann Laparosc Endosc Surg. 2019;4:81. doi: 10.21037/ales.2019.06.08.

25. Starkov Yu.G., Zamolodchikov R. D., Olovyanny V. E., Kuznetsov A. V., Ovechkin A. I. Endoscopy in the Russian Federation. Moscow: RUSTPRESS, 2024. pp. 76-96. (in Russ.)@@ Старков Ю. Г., Замолодчиков Р. Д., Оловянный В. Е., Кузнецов А. В., Овечкин А. И. Эндоскопия в Российской Федерации. М.: РУСТПРЕСС, 2024. С. 76-96.

26. Lemke C., Theis B. Anatomie des ösophagogastrischen Übergangs [Anatomy of the oesophagogastric junction]. Zentralbl Chir. 2014 Feb;139(1):50-7. German. doi: 10.1055/s-0032-1315203.