FLEXIBLE ENDOSCOPY AS AN ADJUNCT TO LAPAROSCOPIC SURGERY

The combination of flexible endoscopy and laparoscopy has allowed a cr eative approach to management of both benign and malignant gastrointes tinal diseases. Historically, attempts to incorporate intraluminal end oscopy with laparoscopy were made early in the historical development of laparoscopy, especially as an aid to stage gastric cancer. The most common modern application is that of flexible choledochoscopy by lapa roscopic cholecystectomy. Other innovative uses include localization o f tumors, control of upper gastrointestinal bleeding, gastric tumor ex cision and biliary decompression, and bowel resection. With imaginatio n guided by sound surgical principles, the combined use of laparoscopy and intraluminal endoscopy should expand the boundaries of general su rgery.