Advertisement

Minimally Invasive Intragastric Surgery

  • Didier MutterEmail author
  • Marius Nedelcu
Chapter

Abstract

As the peritoneal cavity represents the operating space for laparoscopic surgeons, they have imagined directly working in the stomach by following the same principles: insufflation to create a new operating space, introduction of surgical instruments through working ports, and performance of a surgical procedure by using various techniques of dissection. We aim to describe the technical principles of this new approach as it offers a valuable option for surgeons in the management of gastric tumors and early cancer. It may preclude major surgical procedures, especially for the management of lesions located at the esophagogastric junction. Selected indications can be identified due to adequate preoperative workup including endoscopy, endoscopic ultrasonography, and conventional imaging studies (CT scan and MRI). When all inclusion criteria and technical principles are respected, this new minimally invasive approach offers major benefits for patients. It combines the preservation of an almost normal anatomy by respecting the stomach and the gastroesophageal junction with a simple postoperative course.

Keywords

Early Gastric Cancer Gastric Wall Wedge Resection Gastroesophageal Junction Esophagogastric Junction 
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

Video 19.1

Laparoscopic intragastric surgery (MP4 167409 kb)

References

  1. 1.
    Ohashi S. Laparoscopic intraluminal (intragastric) surgery for early gastric cancer. A new concept in laparoscopic surgery. Surg Endosc. 1995;9:169–71.PubMedCrossRefGoogle Scholar
  2. 2.
    Hiki Y, Sakuramoto S, Katada N, et al. Combined laparoscopic- endoscopic procedure in stomach carcinoma. Chirurg. 2000;71:1193–201.PubMedCrossRefGoogle Scholar
  3. 3.
    Sahm M, Pross M, Lippert H. Intraluminal resection of gastric tumors using intragastric trocar technique. Surg Laparosc Endosc Percutan Tech. 2011;21:169–72.CrossRefGoogle Scholar
  4. 4.
    Uchikoshi F, Ito T, Nishida T, Kitagawa T, Endo S, Matsuda H. Laparoscopic intragastric resection of gastric stromal tumor located at the esophago-cardiac junction. Surg Laparosc Endosc Percutan Tech. 2004;14:1–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Hara J, Nakajima K, Takahashi T, et al. Laparoscopic intragastric surgery revisited: its role for submucosal tumors adjacent to the esophagogastric junction. Surg Laparosc Endosc Percutan Tech. 2012;22:251–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Shim JH, Lee HH, Yoo HM. Intragastric approach for submucosal tumors located near the Zline: a hybrid laparoscopic and endoscopic technique. J Surg Oncol. 2011;104:312–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Na JU, Lee SI, Noh SM. The single incision laparoscopic intragastric wedge resection of gastric submucosal tumor. J Gastric Cancer. 2011;11:225–9.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    El-Hayek K, Timratana P, Brethauer SA, Chand B. Complete endoscopic/transgastric retrieval of eroded gastric band: description of a novel technique and review of the literature. Surg Endosc. 2013;27(8):2974–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Son T, Inaba K, Woo Y, Pak KH, Hyung WJ, Noh SH. New surgical approach for gastric bezoar: “hybrid access surgery” combined intragastric and single port surgery. J Gastric Cancer. 2011;11:230–3.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Holeczy P, Danis J. Laparoscopic transgastric pancreatic pseudocystogastrostomy — first experience with extraluminal approach. Hepatogastroenterology. 1998;45:2215–8.PubMedGoogle Scholar
  11. 11.
    Geis WP, Baxt R, Kim HC. Benign gastric tumors. Minimally invasive approach. Surg Endosc. 1996;10:407–10.PubMedCrossRefGoogle Scholar
  12. 12.
    Watson DI, Game PA, Devitt PG. Laparoscopic resection of benign tumors of the posterior gastric wall. Surg Endosc. 1996;10:540–1.PubMedCrossRefGoogle Scholar
  13. 13.
    Weigel TL, Schwartz DC, Gould JC, Pfau PR. Transgastric laparoscopic resection of a giant esophageal lipoma. Surg Laparosc Endosc Percutan Tech. 2005;15:160–2.PubMedCrossRefGoogle Scholar
  14. 14.
    Li VK, Hung WK, Chung CK, et al. Laparoscopic intragastric approach for stromal tumours located at the posterior gastric wall. Asian J Surg. 2008;31:6–10.PubMedCrossRefGoogle Scholar
  15. 15.
    Morinaga N, Sano A, Katayama K. Laparoscopic transgastric tumor-everting resection of the gastric submucosal tumor located near the esophagogastric junction. Surg Laparosc Endosc Percutan Tech. 2004;14:344–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Ma JJ, Hu WG, Zang L, et al. Laparoscopic gastric resection approaches for gastrointestinal stromal tumors of stomach. Surg Laparosc Endosc Percutan Tech. 2011;21(2):101–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Ghushe ND, Dulai PS, Trus TL. Laparoendoscopic transgastric resection of a submucosal mass at the gastroesophageal junction. J Gastrointest Surg. 2012;16:2321.PubMedCrossRefGoogle Scholar
  18. 18.
    Heniford BT, Arca MJ, Walsh RM. The mini-laparoscopic intragastric resection of a gastroesophageal stromal tumor: a novel approach. Surg Laparosc Endosc Percutan Tech. 2000;10:82–5.PubMedGoogle Scholar
  19. 19.
    Choi YB, Oh ST. Laparoscopy in the management of gastric submucosal tumors. Surg Endosc. 2000;14:741–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Ridwelski K, Pross M, Schubert S, et al. Combined endoscopic intragastral resection of a posterior stromal gastric tumor using an original technique. Surg Endosc. 2002;16:537.PubMedCrossRefGoogle Scholar
  21. 21.
    Yumiba T, Ito T, Ikushima H, et al. Effect of mucosal suture on the healing of mucosal defect in laparoscopic intragastric surgery. Gastric Cancer. 2003;6:96–9.PubMedGoogle Scholar
  22. 22.
    Schiu M, Farr G, Papachristou DN, Hajdu S. Myosarcoma of the stomach: natural history, prognostic factors and management. Cancer. 1982;49:177–87.CrossRefGoogle Scholar
  23. 23.
    Llorente J. Laparoscopic gastric resection for gastric leiomyoma. Surg Endosc. 1994;8:887–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Taniguchi E, Kamiike W, Yamanishi H, Ito T, Nezu R, Nishida T, Momiyama T, Ohashi S, Okada T, Matsuda H. Laparoscopic intragastric surgery for gastric leiomyoma. Surg Endosc. 1997;11(3):287–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Asakuma M, Perretta S, Allemann P, Cahill R, Con SA, Solano C, Pasupathy S, Mutter D, Dallemagne B, Marescaux J. Challenges and lessons learned from NOTES cholecystectomy initial experience: a stepwise approach from the laboratory to clinical application. J Hepatobiliary Pancreat Surg. 2009;16(3):249–54.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Digestive and Endocrine Surgery, IRCAD, IHUUniversity Hospital of Strasbourg, Nouvel Hôpital Civil – Pôle Hépato-Digestif, Hôpitaux Universitaires de StrasbourgStrasbourgFrance
  2. 2.Department of Digestive and Endocrine SurgeryUniversity Hospital of Strasbourg, Nouvel Hôpital Civil – Pôle Hépato-Digestif, Hôpitaux Universitaires de StrasbourgStrasbourgFrance

Personalised recommendations