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Surgical Endoscopy

, Volume 29, Issue 1, pp 202–206 | Cite as

Techniques of intragastric laparoscopic surgery

  • Claudius ConradEmail author
  • Marius Nedelcu
  • Satoshi Ogiso
  • Thomas A. Aloia
  • Jean-Nicolas Vauthey
  • Brice Gayet
Dynamic Manuscript

Abstract

Benign or pre-cancerous lesions and foreign bodies of the stomach not amendable to endoscopic removal often require extensive surgery to address a process that does not necessitate lymph node sampling or formal gastrectomy. These lesions are particularly difficult to address endoscopically when located at the esophagogastric junction as a retroflexed view is needed. From its first description in 1995, intragastric laparoscopic surgery has evolved with respect to both technological advancements and tactical innovations. Here we report the development of four distinct techniques of laparoscopic intragastric surgery which we have developed over time and applied in 11 patients. These techniques consist of a (1) combined gastroscopic/laparoscopic approach when minimal manipulation of the lesion is needed, (2) multiport resection which provides optimal triangulation and allows for resection of more complex lesions, (3) stapled removal of broad-based lesions, and (4) single access technique with the device placed directly through the abdominal wall into the stomach. The techniques expand the surgeon’s armamentarium to address more complex intragastric processes safely, while the typical postoperative benefits of minimal access surgery such as fast recovery time and less pain are preserved. As we gain greater experience with intragastric laparoscopic surgery, this technique holds the promise of becoming a standard surgical technique for benign lesions for which it is oncologically safe to perform a limited resection.

Keywords

Minimally invasive gastric surgery Intragastric laparoscopic surgery Single access intragastric surgery SILS gastric surgery Benign gastric lesion Gastric foreign body removal 

Notes

Disclosures

Claudius Conrad, Marius Nedelcu, Satoshi Ogiso, Thomas A. Aloia, Jean-Nicolas Vauthey, Brice Gayet have no conflicts of interests or financial ties to disclose.

Supplementary material

Supplementary material 1 (WMV 235544 kb)

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Claudius Conrad
    • 1
    • 2
    Email author
  • Marius Nedelcu
    • 1
  • Satoshi Ogiso
    • 1
  • Thomas A. Aloia
    • 2
  • Jean-Nicolas Vauthey
    • 2
  • Brice Gayet
    • 1
  1. 1.Institute Mututaliste MontsourisUniversity of Paris DescartesParisFrance
  2. 2.Department of Surgical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

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