Hybrid Resection for Gastric Submucosal Tumor in Combination With Single Port Laparoscopy and Peroral Endoscopy

Noriyuki Inaki, MD PhD, Hisashi Doyama, MD PhD, Yasuhiro Ishiyama, MD, Michihiro Yamamoto, MD, Hiroyuki Bando, MD PhD, Tetsuji Yamada, MD PhD. Ishikawa Prefectural Central Hospital

Background: We developed a hybrid technique for the partial resection of stomach for gastric submucosal tumor (SMT) in combination with the Single Port Surgery (SPS) and peroral endoscopic dissection. The hybrid technique which is called “Laparoscopy and Endoscopy Cooperative Surgery” (LECS), is demonstrated and the clinical results are evaluated.
Methods: LECS in combination with ordinary laparoscopic technique and peroral endoscopic dissection has been introduced to the partial resection of stomach for gastric SMT since May 2008. The procedure with SPS instead of ordinary laparoscopic technique has been introduced since July 2009. Surgical procedure with video; We put skin incision of approximately 2.5cm in the umbilical part and insert one 12mm trocar and two 5mm trocars. Peroral endoscopic full thickness resection is performed, securing least safety margin. During the procedure, SPS technique is performed as assistance. Resected specimen is perorally extracted in plastic bag. The hole of stomach is closed by suturing with SPS technique.
Results: We experienced 14 cases of SMT in total. LECS in combination with SPS and peroral endoscopic technique was performed in 9 cases. There is no complication associated with our technique.
Conclusion: LECS in combination with SPS and peroral endoscopic technique was safe and feasible. It will contribute the quality of life of patients and less invasive surgery.