Endosurgical Applications of EUS

This article provides an overview of the currently practiced EUS-guided endolumenal surgical techniques, which are performed by a few centers throughout the world on a small number of patients. These include EUS-guided drainage of bile and pancreatic ducts, and necrosectomy. Some of the more experimental endosurgical techniques across the G-wall will be addressed, including those procedures that could potentially evolve into clinical routine such as EUS-guided vascular interventions as well as cardiac procedures. Currently, most of them are performed in the experimental animal and only a few in patients. NOTES procedures facilitated under EUS-guidance will be described and include those which can help to achieve safe translumenal access in difficult areas, target pathology with its unique ability to explore and examine the echomorphology of the organs prior to the intended intervention and detect the target within specific anatomy. NOTES EUS-anastomosis, mediastinal procedures, and mediastinal and paragastric lymph-node inspection are some of the most sophisticated surgeries described.