Combined laparoscopic-endoscopic procedures

Combining a (minimally invasive) surgical intervention with simultaneous flexible endoscopy is beneficial in different indications to increase safeness and efficiency. The respective contribution of both modalities to the intervention varies significantly, so one can terminologically distinguish different forms of combined (hybrid) procedures, ranging from simple endoscopic support (for localization of a lesion) via classical laparoscopic-endoscopic combined procedure to hybrid NOTES. As a basic aspect, hybrid interventions are characterized by simultaneous application of laparoscopy and flexible endoscopy and by less invasive tumor therapy where the lesion is approached from different sides (e.g., endoluminal and peritoneal).