Laparoscopic Intragastric Resection: An Alternative Technique for Minimally Invasive Treatment of Gastric Submucosal Tumors. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Boulanger-Gobeil, Cindy; Gagné, Jean-Pierre; Julien, François; Courval, Valérie; Beyfuss, Kaitlyn; Ashamalla, Shady; Hallet, Julie
• Is Part Of: Annals of surgery. Volume 267:Issue 2(2018:Feb.)
• Publication Date: 2018-02
• Subjects: gastric -- laparoscopy -- Stomach neoplasm -- surgery -- technique; Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000002099
• Languages: English
• ISSNs: 0003-4932

Abstract

Abstract : Objective: To present the technique for and early results of laparoscopic intragastric resection (LIGR). Background: Treatment of confirmed or suspected submucosal gastric malignancies relies on clear margin resection, for which minimally invasive surgery is widely accepted. However, resection in some localization remains challenging. Methods: We present the steps of LIGR for gastric submucosal tumors (GSMTs). We report the results of LIGR in consecutive patients operated at 2 institutions, including intraoperative, pathologic, 30-day major morbidity and mortality characteristics. Results: After laparoscopic access to the abdominal cavity, cuffed gastric ports are placed to approximate the anterior gastric wall to the abdominal wall. A pneumogastrum is created. The tumor is resected in the submucosal plane and the deficit closed with intragastric suturing. Specimen extraction is performed perorally or through a gastrotomy site. In 8 proximal intraluminal GSMTs with median size of 3.1 cm (range: 1.8–6.0 cm), median operative time was 167.5 minutes (range: 120–300 mins). There was no major morbidity and no mortality. All resections were R0. Conclusions: We illustrate the technique of a novel, feasible, and safe minimally invasive approach to GSMTs. LIGR is an alternative to resect challenging GSMTs by limiting surgical invasiveness and preserving gastrointestinal function. Abstract : Supplemental Digital Content is available in the text