38. Flexible endoscopy during surgery

Over the last few decades, there has been a constant surgical trend to push forward to less invasive organ-sparing function-preserving procedures. In this respect, flexible endoscopy has rapidly evolved, establishing better diagnostic standards, and improving therapeutic modalities to handle diseases and complications within the lumen of the gastrointestinal (GI) tract. While flexible endoscopy was formerly considered as a subspecialty in the surgical field, it is currently considered a mandatory set of skills in surgical practice. Surgeons perform endoscopy as an essential component of surgical practice and as a set of skills that are critical to treat patients, using increasingly less invasive approaches. As a matter of fact, over the past decade, the American Board of Surgery (ABS) has mandated that all graduated surgeons should be proficient in flexible endoscopy in order to guarantee the best level of care to patients. It is expected that the management of several GI conditions will mostly shift to purely endoscopic therapies in the near future. Although differences in surgical endoscopy expertise requirements may be found worldwide, surgical societies are showing a growing interest in including endoscopic training in the surgical education curriculum. This chapter highlights the use of endoscopy during the most commonly-performed digestive surgeries and it evaluates the future perspectives of this rapidly evolving cutting-edge field.