• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Laparoscopic synchronous left hepatectomy and distal gastrectomy with lymphnodal dissection for carcinoid tumor of the gastric antrum with left lobe liver metastasis

Laparoscopic synchronous left hepatectomy and distal gastrectomy with lymphnodal dissection for carcinoid tumor of the gastric antrum with left lobe liver metastasis

Srikanth Gadiyaram, Dr, Gaurav Singh, Dr, Yashas H Ramegowda, Dr. Sahasra Hospitals, Center of Excellence for Gastroenterology

Background: Surgery remains the mainstay of treatment for neuroendocrine tumors of stomach with resectable liver metastasis. Distal gastrectomy with lymphnodal dissection is increasingly being performed laparoscopically by several centres across the world. Also, laparoscopic left hepatectomy is being performed laparoscopically in some centres routinely. We herein present an operative video of laparoscopic synchronous resection, viz; laparoscopic distal gastrectomy with lymphnode dissection and left hepatectomy.

Case report: 65 year old lady evaluated with upper gastroscopy for evaluation of upper abdominal pain had a antral tumor which was confirmed to be a carcinoid tumor on histopathology and immunohistochemistry. A DOTANOC-PETCT showed an increased uptake in gastric antral lesion, hepato-duodenal enlarged lymphnodes and uptake in lesions in Segment 2, 3 and 4 of liver and no uptake elsewhere. The patient was planned for the aforementioned operative procedure which was performed in the following steps

Step 1 – Five port laparoscopic procedure. Lesser sac was opened, right gastroepiploic vessels dissected and divided. First part of duodenum looped and staple transected

Step 2 – Hepatoduodenal lymphnode clearance done

Step 3 – Left hepatic artery looped, ligated and divided. Left portal vein looped and ligated in continuity

Step 4 – Line of demarcation marked out. Parenchymal transection done using harmonic for superficial transection, CUSA for deeper parenchymal transection, and structures 3 mm or more clipped and divided. The left portal pedicle was staple (endo GIA vascular load) transected, and left hepatic vein encountered during deeper dissection, was dissected and secured with an endo GIA vascular load. The left triangular ligament was divided.

Step 5 – Proximal gastric marging for transection defined, and staple divided

Step 6 – Specimen retrieval, viz; distal stomach, lymphnodes and left liver placed in endobag and removed through 5 cm left subcostal incision.

Step 7 – Gastrojejunostomy completed through the wound of specimen retrieval

Step 8 – Hemostasis checked , lavage done and drain placed along transected liver and excited from right anterior axillary line port.

Conclusions: Synchronous laparoscopic gastrectomy and major hepatectomy is safe and feasible. This has to be viewed keeping in mind the potential need for repeat surgeries in these patients in the long term for any recurrent disease.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93928

Program Number: P506

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

View this Poster

17

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals