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RESECTION OF STROMAL TUMOR BY MINILAPAROSCOPY ASSISTED BY UPPER GI ENDOSCOPY: A CASE REPORT

Diego L Lima, MD1, Gustavo L Carvalho, MD, phD2, Gustavo H Belarmino de Goes, Medical Student2, Raquel N Cordeiro, Medical Student3, Gustavo A Carvalho, MD2. 1State Servers Hospital, 2University of Pernambuco, 3Health Faculty of Pernambuco

Case Report: A 62-year-old male patient, who had had melena for about a year. Upper GI endoscopy and biopsy showed a gastrointestinal stromal tumor (GIST) in the stomach. A videolaparoscopic partial gastrectomy was then proposed. The surgery was performed with the patient in the right lateral decubitus. Two 3-mm minilaparoscopic trocars, a 5-mm conventional trocar for an ultrasonic instrument and a 10-mm trocar in the umbilical region for the camera were used. Pneumoperitoneum was created using the Hasson open technique under direct vision. Trans-operatory endoscopy was perfomed to identify the tumor easily. Initially, the ultrasonic device released the large omentum, and, then, the tumor was resected in the body of the stomach. The gastric wall was manually sutured with a 2-0 Vicryl, and the tumor was removed in an endobag through the 10-mm incision in the umbilicus. The surgery was uneventful, with a total time of 72 minutes. The patient had no further complications, being discharged two days after the procedure with good clinical conditions. Histopathological result showed a free margins GIST.

Conclusion: The minimally invasive approach proved to be safe and effective for this procedure. The known advantages of video-surgery such as less trauma, better visualization, increased dexterity, better esthetics, and less postoperative recovery time were confirmed. The Upper GI endoscopy contributed to improve the safety and efficacy of the procedure, allowing a more precise resection of the GIST, as well as the intragastric review of the suture line at the end of the surgery. 


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

Abstract ID: 86702

Program Number: P157

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

31

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