Flexible endoscopy as an adjunct to laparoscopic surgery.

The combination of flexible endoscopy and laparoscopy has allowed a creative approach to management of both benign and malignant gastrointestinal diseases. Historically, attempts to incorporate intraluminal endoscopy 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 laparoscopic cholecystectomy. Other innovative uses include localization of tumors, control of upper gastrointestinal bleeding, gastric tumor excision and biliary decompression, and bowel resection. With imagination guided by sound surgical principles, the combined use of laparoscopy and intraluminal endoscopy should expand the boundaries of general surgery.