Laparo-Endoscopic Single Site (LESS) Resection of Gastrointestinal Stromal Tumor

Sharona B Ross, MD, Vasilios K Nenos, BS, Ty A Bowman, BS, Darrell J Downs, ATC, Whalen Clark, MD, Alexander S Rosemurgy, MD. Florida Hospital Tampa

Through a 12mm incision at the umbilicus, four low profile 5mm trocars were utilized in a single multi-trocar port. Pneumoperitoneum was established. Short gastric vessels were divided and gastric mobilization was achieved using LESS techniques. Utilizing an ultrasonic dissector the tumor was excised from the fundus and placed into an extraction bag. The resulting gastrotomy was initially closed with 0 polyester stay sutures.  This allowed us to fire an Endo-GIA stapling device to obtain both another margin as well as a secure closure of the gastrotomy. The resected portion of the stomach was placed into a secondary extraction bag. The two extraction bags were removed through the umbilicus. Pathology confirmed clean margins. The greater peritoneal cavity was irrigated with dilute bupivacaine before and after closing. The umbilicus was closed with Maxon, followed by Vicryl.

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