Technical considerations for the minimally invasive management of mesenchymal tumors of the stomach

Christopher S Armstrong, MD, FRCSC, Ninh T Nguyen, MD, FACS, Brian R Smith, MD, FACS

University of California Irvine Medical Center

Mesenchymal tumors are uncommon neoplasms of the stomach. Determination of the size and location of these tumors is critical during preoperative planning and for determining the best surgical approach. These lesions are often easily resected using minimally invasive techniques when they present in a favourable location but can be particularly challenging to resect when they present adjacent to the gastroesophageal junction or in the pre-pyloric region. Furthermore, these tumors can also present with concomitant foregut pathology that requires additional surgical management. We present 5 cases of gastric mesenchymal tumors in this video that highlight some of the technical aspects involved in the minimally invasive management of these lesions.

Case 1: An exophytic gastric GIST of the anterior wall managed with partial gastrectomy

Case 2: A posteriorly located gastric GIST with concurrent hiatal hernia managed with partial gastrectomy and hiatal hernia repair

Case 3: posteriorly based leiomyoma at the gastroesophageal junction managed with enucleation through an anterior gastrotomy

Case 4: a small leiomyoma immediately adjacent to the gastroesophageal junction managed with laparoendoscopic transgastric enucleation

Case 5: a large leiomyoma of the gastroesophageal junction managed with transmural enucleation


Session: Video ChannelDay 2

Program Number: V074

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