Skip to main content

Robotic Segmental Gastrectomy for Large Gastrointestinal Stromal Tumor

  • Chapter
  • First Online:
Minimally Invasive Surgical Techniques for Cancers of the Gastrointestinal Tract

Abstract

Gastrointestinal stromal tumors (GISTs) are common soft tissue tumors of the gastrointestinal tract and are frequently encountered in surgical practice. The most common location for GISTs is the stomach. Principles of surgical management of resectable GISTs include removal with negative margins and no requirement for regional lymphadenectomy. Both open and minimally invasive surgical approaches have been utilized with noticeable trends toward laparoscopic and robotic techniques. There is little data on the robotic approach; however, small case series have reported favorable results. In fact, robotic techniques may allow surgeons to perform resections in more challenging locations. In this chapter, we describe a step-by-step approach to resection of a large GIST of the proximal stomach near the cardia with subsequent closure of the defect using the robotic platform.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kindblom LG, Remotti HE, Aldenborg F, et al. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol. 1998;152(5):1259–69.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol. 1999;30(10):1213–20.

    Article  CAS  Google Scholar 

  3. Ma GL, Murphy JD, Martinez ME, et al. Epidemiology of gastrointestinal stromal tumors in the era of histology codes: results of a population-based study. Cancer Epidemiol Biomarkers Prev. 2015;24(1):298–302.

    Article  Google Scholar 

  4. Choi AH, Hamner JB, Merchant SJ, et al. Underreporting of gastrointestinal stromal tumors: is the true incidence being captured? J Gastrointest Surg. 2015;19(9):1699–703.

    Article  Google Scholar 

  5. DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231(1):51–8.

    Article  CAS  Google Scholar 

  6. Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23(2):70–83.

    Article  Google Scholar 

  7. Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol. 2005;29(1):52–68.

    Article  Google Scholar 

  8. Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279(5350):577–80.

    Article  CAS  Google Scholar 

  9. Dematteo RP, Ballman KV, Antonescu CR, et al. Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. Lancet. 2009;373(9669):1097–104.

    Article  CAS  Google Scholar 

  10. Joensuu H, Eriksson M, Sundby Hall K, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA. 2012;307(12):1265–72.

    Article  CAS  Google Scholar 

  11. Tokunaga M, Ohyama S, Hiki N, et al. Incidence and prognostic value of lymph node metastasis on c-Kit-positive gastrointestinal stromal tumors of the stomach. Hepato-Gastroenterology. 2011;58(109):1224–8.

    PubMed  Google Scholar 

  12. De Vogelaere K, Hoorens A, Haentjens P, et al. Laparoscopic versus open resection of gastrointestinal stromal tumors of the stomach. Surg Endosc. 2013;27(5):1546–54.

    Article  Google Scholar 

  13. MacArthur KM, Baumann BC, Nicholl MB. Laparoscopic versus open resection for gastrointestinal stromal tumors (GISTs). J Gastrointest Cancer. 2017;48(1):20–4.

    Article  Google Scholar 

  14. De Vogelaere K, Van Loo I, Peters O, et al. Laparoscopic resection of gastric gastrointestinal stromal tumors (GIST) is safe and effective, irrespective of tumor size. Surg Endosc. 2012;26(8):2339–45.

    Article  Google Scholar 

  15. Lin J, Huang C, Zheng C, et al. Laparoscopic versus open gastric resection for larger than 5 cm primary gastric gastrointestinal stromal tumors (GIST): a size-matched comparison. Surg Endosc. 2014;28(9):2577–83.

    Article  Google Scholar 

  16. Huang CM, Chen QF, Lin JX, et al. Can laparoscopic surgery be applied in gastric gastrointestinal stromal tumors located in unfavorable sites?: a study based on the NCCN guidelines. Medicine. 2017;96(14):e6535.

    Article  Google Scholar 

  17. Vicente E, Quijano Y, Ielpo B, et al. Robot-assisted resection of gastrointestinal stromal tumors (GIST): a single center case series and literature review. Int J Med Rob Compu Assisted Surg. 2016;12(4):718–23.

    Article  Google Scholar 

  18. Buchs NC, Bucher P, Pugin F, et al. Robot-assisted oncologic resection for large gastric gastrointestinal stromal tumor: a preliminary case series. J Laparoendosc Adv Surg Tech A. 2010;20(5):411–5.

    Article  Google Scholar 

  19. Desiderio J, Trastulli S, Cirocchi R, et al. Robotic gastric resection of large gastrointestinal stromal tumors. Int J Surg. 2013;11(2):191–6.

    Article  Google Scholar 

  20. Andtbacka RH, Ng CS, Scaife CL, et al. Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. Ann Surg Oncol. 2007;14(1):14–24.

    Article  Google Scholar 

  21. Eisenberg BL, Harris J, Blanke CD, et al. Phase II trial of neoadjuvant/adjuvant imatinib mesylate (IM) for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor (GIST): early results of RTOG 0132/ACRIN 6665. J Surg Oncol. 2009;99(1):42–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph Kim .

Editor information

Editors and Affiliations

Electronic Supplementary Material

Robotic resection of gastric tumor (MOV 323550 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Merchant, S., Pyke, O., Kim, J. (2020). Robotic Segmental Gastrectomy for Large Gastrointestinal Stromal Tumor. In: Kim, J., Garcia-Aguilar, J. (eds) Minimally Invasive Surgical Techniques for Cancers of the Gastrointestinal Tract. Springer, Cham. https://doi.org/10.1007/978-3-030-18740-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18740-8_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18739-2

  • Online ISBN: 978-3-030-18740-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics