Zhongshan Protocol Reshapes Digestive Tract Surgery by Putting Endoscopy in the Lead

At the 2026 Shanghai Digestive Endoscopy Academic Conference, Zhongshan Hospital, Fudan University released the Zhongshan Protocol for endoscopy-laparoscopy combined surgery (ELCS), completely overturning the established dual-endoscope model in which laparoscopy leads and endoscopy assists, and for the first time worldwide placing endoscopy in the dominant role. Taking the duodenum, which has a complex anatomical structure and has long been regarded as a forbidden zone for surgery, as an example, the endoscope precisely dissects the lesion from inside the lumen while the laparoscope provides external protection, real-time monitoring and fine suturing, both completely removing the tumor and avoiding the risk of perforation, while preserving the anatomical structure and physiological function of the digestive tract to the greatest extent. The conference also released a number of updated guidelines and expert consensus documents on minimally invasive endoscopic techniques, standardizing and upgrading the super minimally invasive procedures pioneered by Professor Zhou Pinghong's team, such as POEM and G-POEM, and expanding their indications worldwide.

The conference brought together more than 3,500 experts and scholars from around the globe, with 18 sub-forums and 25 keynote presentations.