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Annals of Surgical Oncology

, Volume 18, Issue 1, pp 191–191 | Cite as

Single-Incision Transumbilical Laparo-Endoscopic Gastric Benign Tumor Resection

  • Giovanni DapriEmail author
  • Ruffin Ntounda
  • Jacques Himpens
  • Pietro Carnevali
  • Serena Scomersi
  • Guy-Bernard Cadière
Gastrointestinal Oncology

Abstract

Introduction

The authors report resection of a gastric benign tumor through single-incision laparoscopy, guided by peroperative gastroscopy.

Video

A 25-year-old man consulted after diagnosis of a 40 × 20 cm2 endoluminal lesion of the gastric cardia. Preoperative work-up showed a stromal tumor with invasion of the muscular layer. The umbilical scar was incised and, after placement of a purse-string suture, an 11-mm nondisposable trocar was inserted for a 10-mm 30° angled scope. Curved and reusable instruments (Karl Storz-Endoskope, Tuttlingen, Germany) and straight ultrasonic shears (Ethicon Endosurgery, Cincinnati, OH, US) were inserted transumbilically. Peroperative gastroscopy located the lesion on the smaller gastric curvature, 1 cm from the gastroesophageal junction. A stitch was placed in the center of the lesion, and gastroscopic grasper helped in maintaining the limits of resection. Gastrostomy was closed using two converting absorbable running sutures. Because of the curves of the instruments there was no conflict between the instruments' tips inside the abdomen (Fig. 1a), or between the surgeon's hands outside the abdomen (Fig. 1b). Leak test with the gastroscope checked the integrity of the suture. The specimen was retrieved transumbilically in a plastic bag.

Results

Operative time was 150 min, and the umbilical incision was less than 15 mm. The patient was discharged after 5 days, and he is doing well 3 months postoperatively.

Conclusions

Laparoscopic gastric resection can be safely performed through a single-access. Peroperative gastroscopy permits the limits of resection to be precisely determine, and use of curved and reusable instruments allows surgeon to achieve ergonomic conditions as in classic laparoscopy, without increasing the laparoscopic cost.

Keywords

Stromal Tumor Gastroesophageal Junction Muscular Layer Gastric Cardia Leak Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Supplementary material 1 (MPG 74256 kb)

Copyright information

© Society of Surgical Oncology 2010

Authors and Affiliations

  • Giovanni Dapri
    • 1
    Email author
  • Ruffin Ntounda
    • 2
  • Jacques Himpens
    • 1
  • Pietro Carnevali
    • 1
  • Serena Scomersi
    • 1
  • Guy-Bernard Cadière
    • 1
  1. 1.Department of Gastrointestinal SurgeryEuropean School of Laparoscopic Surgery, Saint-Pierre University HospitalBrusselsBelgium
  2. 2.Department of Gastroenterology and EndoscopySaint-Pierre University HospitalBrusselsBelgium

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