Surgery Today

, Volume 45, Issue 5, pp 641–646 | Cite as

Single-port laparoscopic and endoscopic cooperative surgery for a gastric gastrointestinal stromal tumor: report of a case

  • Toru ObuchiEmail author
  • Akira Sasaki
  • Shigeaki Baba
  • Hiroyuki Nitta
  • Koki Otsuka
  • Go Wakabayashi
Case Report


We herein report a case of single-port laparoscopic and endoscopic cooperative surgery (LECS) for a gastric gastrointestinal stromal tumor (GIST). A 75-year-old female with an endoluminal GIST located near the esophagogastric junction underwent LECS. Both the mucosal and submucosal layers around the tumor were circumferentially dissected using endoscopic submucosal dissection via intraluminal endoscopy. The endoluminal GIST was exteriorized to the abdominal cavity. The tumor and the edge of the incision line were closed using an endoscopic linear stapler. The LECS was successfully accomplished without the need for any skin incisions or additional ports. The length of the operation was 120 min and blood loss was 5 ml. Oral intake was resumed on the second day and the length of hospital stay was 5 days. No complications were noted and the patient had an excellent cosmetic result. In our experience, single-port LECS is feasible and safe for gastric GIST when performed by a surgeon experienced in laparoscopic and gastric surgery.


Laparoscopic and endoscopic cooperative surgery (LECS) Gastrointestinal stromal tumor Laparoscopic gastric resection Single-port surgery Single-incision surgery 


Conflict of interest

Toru Obuchi and the co-authors have no conflict of interest to declare.


  1. 1.
    Yoshikawa K, Shimada M, Kurita N, Sato H, Iwata T, Morimoto S, Miyatani T, Kashihara H, Takasu C, Matsumoto N. The efficacy of PET-CT for predicting the malignant potential of gastrointestinal stromal tumors. Surg Today. 2013;43:1162–7.CrossRefPubMedGoogle Scholar
  2. 2.
    DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51–8.CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Novitsky YW, Kercher KW, Sing RF, Heniford BT. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg. 2006;243:738–45.CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Sasaki A, Koeda K, Obuchi T, Nakajima J, Nishizuka S, Terashima M, et al. Tailored laparoscopic resection for suspected gastric gastrointestinal stromal tumors. Surgery. 2009;147:516–20.CrossRefPubMedGoogle Scholar
  5. 5.
    Lee PC, Lo C, Lai PS, Chang JJ, Huang SJ, Lin MT, et al. Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg. 2010;97:1007–12.CrossRefPubMedGoogle Scholar
  6. 6.
    Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S. Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg. 2011;254:22–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Sasaki A, Ogawa M, Tono C, Obara S, Hosoi N, Wakabayashi G. Single-port versus multiport laparoscopic cholecystectomy: a prospective randomized clinical study. Surg Laparosc Endosc Percutan Tech. 2012;22:396–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Sasaki A, Koeda K, Nakajima J, Obuchi T, Baba S, Wakabayashi G. Single-incision laparoscopic gastric resection for submucosal tumors: report of three cases. Surg Today. 2011;41:133–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Hirano Y, Watanabe T, Uchida T, Yoshida S, Kato H, Hosokawa O. Laparoendoscopic single site partial resection of the stomach for gastrointestinal stromal tumor. Surg Laparosc Endosc Percutan Tech. 2010;20:262–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Park JY, Eom BW, Yoon H, Ryu KW, Kim YW, Lee JH. Transumbilical single-incision laparoscopic wedge resection for gastric submucosal tumors: technical challenges encountered in initial experience. J Gastric Cancer. 2012;12:173–8.CrossRefPubMedCentralPubMedGoogle Scholar
  11. 11.
    Nishida T, Hirota S, Yanagisawa A, Sugino Y, Minami M, Yamamura Y, GIST Guideline Subcommittee, et al. Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version. Int J Clin Oncol. 2008;13:416–30.CrossRefPubMedGoogle Scholar
  12. 12.
    Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.CrossRefPubMedGoogle Scholar
  13. 13.
    Pelosi MA, Pelosi MA III. Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med. 1992;37:588–94.PubMedGoogle Scholar
  14. 14.
    Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I. One wound laparoscopic cholecystectomy. Br J Surg. 1997;84:695.CrossRefPubMedGoogle Scholar
  15. 15.
    Hwang SH, do Park J, Kim YH, Lee KH, Lee HS, Kim HH, et al. Laparoscopic surgery for submucosal tumors located at the esophagogastric junction and the prepylorus. Surg Endosc. 2009;23:1980–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Hiki N, Yamamoto Y, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, et al. Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection. Surg Endosc. 2008;22:1729–35.CrossRefPubMedGoogle Scholar
  17. 17.
    Hiki N, Fukunaga T, Miki A, Tokunaga M, Ohyama S, Seto Y, et al. New technique for laparoscopic wedge resection for gastric submucosal tumor: laparoscopy endoscopy cooperative surgery. Jpn J Gastroenterol Surg. 2008;41:1661–8.CrossRefGoogle Scholar
  18. 18.
    Tsujimoto H, Yaguchi Y, Kumano I, Takahata R, Ono S, Hase K. Successful gastric submucosal tumor resection using laparoscopic and endoscopic cooperative surgery. World J Surg. 2012;36:327–30.CrossRefPubMedGoogle Scholar
  19. 19.
    Kawahira H, Hayashi H, Natsume T, Akai T, Uesato M, Horibe D, et al. Surgical advantages of gastric SMTs by laparoscopy and endoscopy cooperative surgery. Hepatogastroenterology. 2012;59:415–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Kang W-M, Yu J-C, Ma Z-Q, Zhao Z-R, Meng Q-B, Ye X. Laparoscopic–endoscopic cooperative surgery for gastric submucosal tumors. World J Gastroenterol. 2013;19:5720–6.CrossRefPubMedCentralPubMedGoogle Scholar
  21. 21.
    Qiu WQ, Zhuang J, Wang M, Liu H, Shen ZY, Xue HB, et al. Minimally invasive treatment of laparoscopic and endoscopic cooperative surgery for patients with gastric gastrointestinal stromal tumors. J Dig Dis. 2013;14:469–73.CrossRefPubMedGoogle Scholar
  22. 22.
    Aogi K, Hirai T, Mukaida H, Toge T, Haruma K, Kajiyama G. Laparoscopic resection of submucosal gastric tumors. Surg Today. 1999;29:102–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  • Toru Obuchi
    • 1
    Email author
  • Akira Sasaki
    • 1
  • Shigeaki Baba
    • 1
  • Hiroyuki Nitta
    • 1
  • Koki Otsuka
    • 1
  • Go Wakabayashi
    • 1
  1. 1.Department of SurgeryIwate Medical University School of MedicineMoriokaJapan

Personalised recommendations