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Laparoscopic Transgastric Resection of a Gastric Submucosal Tumor near Esophagogastric Junction with Concomitant Sleeve Gastrectomy: a Video Case Report

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Abstract

Background

Over the past two decades, there has been a significant rise in bariatric surgery. As a consequence, the prevalence of obese patients with a combined gastric pathology such as a submucosal tumor (SMT) requiring excision at the same time as bariatric surgery is higher but the management remains controversial. We report the safety and effectiveness of a simultaneous laparoscopic transgastric resection of a large gastric SMT near the esophagogastric junction (EGJ) with sleeve gastrectomy (SG).

Methods

We present a video report of a 52-year-old male (BMI = 49 kg/m2) referred for bariatric surgery, who was found to have a large SMT 2 cm from the EGJ on the lesser curvature on previous gastroscopy.

Results

Using five ports placed for laparoscopic SG, the gastric SMT was localized through an anterior gastrotomy and fully excised using a linear stapler and the gastrotomy site was closed. SG was then performed over a 54Fr bougie, including the gastrotomy suture closure.

Conclusions

Several factors play important roles in deciding the best surgical approach for patients who are candidates for bariatric surgery and have concomitant gastric SMTs. This video report describes a safe and effective technique of simultaneous transgastric resection of a lesser curvature gastric SMT near the EGJ in a patient undergoing SG.

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Author information

Authors and Affiliations

  1. Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada

    Saeed Alshlwi, Aly Elbahrawy, Hussam Alamri, Sara Najmeh, Rajesh Aggarwal, Sebastian Demyttenaere, Olivier Court & Amin Andalib

  2. McGill University Health Center, Montreal General Hospital, 1650 Cedar Avenue; Rm: E16-165A, Montreal, QC, H3G 1A4, Canada

    Amin Andalib

Authors
  1. Saeed Alshlwi
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  2. Aly Elbahrawy
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  3. Hussam Alamri
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  4. Sara Najmeh
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  5. Rajesh Aggarwal
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  6. Sebastian Demyttenaere
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  7. Olivier Court
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  8. Amin Andalib
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Corresponding author

Correspondence to Amin Andalib.

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Conflict of Interest

SA, AE, HA, SN, SD, and AA do not have any conflicts of interest or financial ties to disclose. RA reports personal fees from Applied Medical, outside the submitted work. OC reports grants from Ethicon/Johnson & Johnson, outside the submitted work.

Informed Consent

Informed consent was obtained from the patient for the planned surgical procedure and the video case report.

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Alshlwi, S., Elbahrawy, A., Alamri, H. et al. Laparoscopic Transgastric Resection of a Gastric Submucosal Tumor near Esophagogastric Junction with Concomitant Sleeve Gastrectomy: a Video Case Report. OBES SURG 27, 552–553 (2017). https://doi.org/10.1007/s11695-016-2450-3

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  • DOI: https://doi.org/10.1007/s11695-016-2450-3

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