Endoscopic Deeper Layer Dissection

Endoscopy was first developed as a diagnostic tool. Over the years, researchers have started to perform therapeutic procedures using the endoscope. Recently, interests have gathered over the use of the endoscope for complex non-invasive therapeutic endoscopic procedures. These procedures include endoscopic submucosal dissection, endoscopic mucosal resection, and endoscopic full thickness resection. However, challenges abound for the performance of endoscopic deeper layer dissection. These obstacles include – firstly, the difficulty of using existing archaic endoscopic instruments with minimal degrees of freedom to achieve adequate retraction; and secondly, the lack of intraluminal working space should perforation occur, or full thickness incision be performed. Advances, such as technological enhancements and improvements to the current endoscope, must be achieved to allow endoscopists to perform procedures that cannot be achieved using existing endoscopic instruments. A case in point – robotic technology can be incorporated to develop instruments with high degrees of freedom. This provides optimal retraction of tissues and adequate exposure of the operating field. Research should also focus on the development of appropriate technological devices to maintain adequate intraluminal working space. This collection therefore comprises articles describing the latest developments in endoscopic deeper layer dissection. I hope that readers will find this volume a valuable addition to the emerging field of complex endoscopic therapeutic procedures.