Laparoendoscopic

Laparoendoscopic refers to surgical approaches that combine laparoscopic techniques with endoscopic visualization and instrumentation to perform minimally invasive procedures in the abdominal and pelvic cavities. The term describes methods that integrate access via small abdominal incisions with targeted visualization and instrument passage through endoscopic channels, enabling complex dissection, resection, and reconstruction with reduced tissue trauma. Laparoendoscopic techniques underpin practices such as laparoendoscopic single-site surgery and, more broadly, the field surrounding natural-orifice and endoscopic strategies.

Procedural elements typically involve a laparoscope for internal visualization, endoscopes or flexible scopes for augmented view and access, and the use of CO2 insufflation to create a working space. Equipment may include multichannel access devices, energy devices compatible with both laparoscopic and endoscopic use, and specialized graspers or staplers. Examples of techniques within this realm include less invasive, single-incision approaches as well as hybrid methods that combine transabdominal laparoscopy with transorifice endoscopic steps to facilitate complex procedures.

Applications span multiple specialties, including urology, gynecology, general surgery, and pediatric surgery. Procedures may combine ureteroscopic or gastroscopic endoscopy with laparoscopy to enhance visualization or precision during nephrectomy, pyeloplasty, stone management, myomectomy, sacrocolpopexy, or partial resections of biliary or colorectal lesions. The exact configuration depends on the clinical goal, anatomy, and available equipment.

Advantages of laparoendoscopic techniques typically include smaller incisions, reduced postoperative pain, faster recovery, and improved cosmetic outcomes. Limitations include a steep learning curve, longer operative times during adoption, higher equipment costs, and the need for careful patient selection and specialized training to manage potential complications from both laparoscopic and endoscopic components. Ongoing developments in robotics, imaging, and hybrid NOTES approaches continue to expand its applications.