After a Health Technology Assessment on 3D vision technology completed last year, the aim of one of the consensus meetings 2018 of the EAES was to generate a guideline on the same topic based on best available evidence and expert opinions of EAES Technology Committee members. After a systematic review of the literature by an international group of research fellows, an expert panel with extensive engineering and clinical experience in the use of 3D vision technology discussed statements and recommendations. Twenty-two statements and 2 recommendations were obtained unanimously by the experts and were discussed and voted at the consensus meeting of the EAES in London in May 2018 by the attendees of the meeting. The most important regarding general topics were: a) 3D vision improves outcomes for junior trainees in performing standardized tasks in box trainers, only when 3D systems with HD screen and passive polarized glasses are used and only when properly set up; b) The use of 3D imaging systems improves laparoscopic box trainer task completion time and error rate but this benefit has not been studied in clinical practice. The most important regarding clinical setting were: a) 3D laparoscopy shortens the operating time in all the analysed surgical settings (general surgery, urology and gynaecology); b) The pooling of data from the different settings seems to suggest a lowering in the overall rate of complications after surgical procedures involving suturing in 3D laparoscopy, especially in the gynaecology setting; indeed data are too heterogeneous and weak to sustain any recommendation, other than implications for future research. These produced 2 recommendations: a) 3D laparoscopy might shorten operative times; b) Future research is recommended to demonstrate that 3D vision may lower complications rate in laparoscopy. The majority of the EAES members supported these statements.These consensus proceedings provide additional guidance to surgeons and surgical residents providing help when using 3D vision technology.

ObjectivesEsophageal squamous cell carcinoma (ESCC) is one of the most aggressive malignancies owing to the high frequency of tumor recurrence. The identification of markers for early ESCC diagnosis and prediction of recurrence is expected to improve the long-term prognosis. Therefore, we searched for associations between tumor recurrence and cell-free DNA (cfDNA) mutations in blood plasma, which contains genetic markers for various cancer types.Experimental DesignGenomic DNA from tumors and cfDNA from plasma were obtained from 13 patients undergoing treatment for newly diagnosed ESCC. Next-generation sequencing of cfDNA in plasma was performed to identify mutations in 53 cancer-related genes, in which recurrent mutations were previously detected in ESCC. cfDNA mutational profiles were compared before and after tumor resection in four patients. Furthermore, somatic mutations in serial plasma samples were monitored after treatment in four patients.ResultsWe identified multiple concordant somatic mutations in cfDNA and primary tumor samples from 10 patients (83.3%) and in cfDNA and metastatic tumor samples from one patient (100%). Furthermore, the allele frequency of the concordant mutations in cfDNA changed concomitantly with tumor burden and increased approximately 6 months earlier than the detection of tumor recurrences by imaging tests in two patients. Conventional biomarkers, such as SCC and p53-Ab, did not reflect tumor recurrences.ConclusionsThe present multigene panel, which enabled the diagnosis of tumor recurrence with greater accuracy than did using standard tumor markers or imaging methods, is expected to greatly facilitate standard, postoperative follow-up monitoring in ESCC.

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We have demonstrated the development of a unique technical ESD method facilitated by a new double-balloon device. Ex and in vivo investigation demonstrated superiority of ESD-R over the conventional ex vivo method. The DB device provided increased stability, improved visualization and tissue traction, which significantly reduced dissection time. Such an approach may increase safety, improve patient outcomes, and may prevent unnecessary surgeries for benign conditions.