Mucosasparing

Mucosasparing refers to surgical and endoscopic approaches that strive to preserve mucosal tissue during procedures that would otherwise disrupt or remove it. The term applies to mucosa lining many tracts, including the gastrointestinal, respiratory, urogenital, and oral cavities. The overarching goal is to maintain the continuity and function of the mucosal barrier while achieving the therapeutic objective.

Rationale and mechanisms: Preserving mucosa can reduce postoperative complications such as fistula formation, infection, bleeding, and strictures, and may promote faster healing and better preservation of normal mucosal function and flora. Techniques emphasize careful dissection along natural tissue planes, limited mucosal resection when possible, and the use of mucosa-sparing flaps or reconstruction methods to maintain surface integrity.

Techniques and applications: Mucosasparing strategies are used across multiple specialties, including abdominal and colorectal surgery, gynecology, urology, dentistry, and various endoscopic procedures. Examples include meticulous, plane-oriented dissection to avoid full-thickness injury, the deployment of mucosa-preserving reconstructions, and minimally invasive access that limits mucosal disruption. The choice of technique depends on the specific anatomy, pathology, and goals of treatment, and may involve imaging guidance and advanced instrumentation.

Outcomes and limitations: When feasible, mucosasparing approaches can be associated with reduced postoperative morbidity, preserved mucosal function, and improved patient recovery. Limitations arise when the lesion or disease process necessitates mucosal excision or when anatomy restricts preservation, requiring a balance between therapeutic efficacy and mucosal preservation.

History and terminology: The concept aligns with the broader movement toward organ- and tissue-preserving strategies and has gained prominence with advances in minimally invasive surgery and endoscopy.