Endoscopy assisted laparoscopic intragastric surgery for stromal tumor

Hussein Wissanji, MD, Jean-Pierre Gagne, MD. University Laval.

Introduction: Mesenchymal tumors constitute 1 % of primary GI cancer. Surgical treatment of gastric gastrointestinal stromal tumor (GIST) is the only known curative therapy. Traditionally, management involves a wedge resection. A problematic exists for tumor located at gastric cardia due to the proximity of the lower esophageal sphincter. This video presents a combined laparoscopic and endoscopic technique for resection of submucosal lesions located at the gastro-esophageal junction.

Method: An endoscopy assisted laparoscopic intragastric surgery was utilized to resect a 2 cm submucosal lesion located at the gastric cardia. This was executed using both transabdominal and transgastric trocars under endoscopic guidance.

Results: Final histopathology showed a GIST with negative margins. The patient was discharged home on post-operative day 4.

Conclusion: Gastric submucosal lesion at the cardia can be safely resected using a combined laparoendoscopic approach.

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