ReviewWorld journal of gastrointestinal endoscopy2025
Mastering the third space: Innovations in intramural endoscopic surgery for gastrointestinal disorders.
Review in World journal of gastrointestinal endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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0 citing papers in PubMed.
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Third-space endoscopy, also known as intramural surgery, represents a major evolution in minimally invasive gastrointestinal interventions. While natural orifice transluminal endoscopic surgery provided early conceptual groundwork, third-space endoscopy builds upon it by maintaining interventions within the submucosal layer, offering improved precision and reduced risk. The creation of a controlled submucosal working space enables precise therapeutic interventions while potentially reducing the morbidity associated with traditional surgical approaches. Among its most impactful applications are the peroral endoscopic myotomy techniques, including cricopharyngeal, esophageal, gastric, and Zenker's myotomies. These procedures have redefined the management of cricopharyngeal bar, achalasia, gastroparesis, and Zenker's diverticulum, respectively. These techniques offer durable symptom relief with reduced recovery times. Over the past five years, refinements in technique, advancements in instrumentation, technology, and improved patient selection have expanded indications and enhanced safety. However, challenges remain, including the limited standardization and accessibility to specialized training. This review provides a comprehensive analysis of the evolution, technical refinements, and clinical outcomes of third-space endoscopy, with a focus on its expanding role in foregut surgery. By consolidating current evidence and highlighting future directions, we aim to provide a critical perspective on the impact of intramural surgery and its potential to further transform the management of complex gastrointestinal disorders.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.