Transumbilical Single-Access Laparoscopic Perforated Gastric Ulcer Repair

Giovanni Dapri, MD FACS FASMBS, Haicam El Mourad, MD, Luisa Marsili, MD, Jacques Himpens, MD, Guy Bernard Cadière, MD PhD. European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium

 

Background: Single-access laparoscopy (SAL) can be proposed in patients presenting peritonitis both for diagnosis and treatment. This video shows a transumbilical SAL performed for perforated gastric ulcer.
Video: A 30 year-old female with a body mass index of 22.9 kg/m² was admitted to the emergency room for diffuse abdominal pain. Preoperative work-up showed a pneumoperitoneum, hence a SAL was proposed to the patient. The procedure was performed using a standard 11-mm reusable trocar for a 10-mm, standard length, 30° scope, and curved reusable instruments inserted transumbilically without trocars. The cavity exploration showed a perforated gastric ulcer at the anterior surface of the prepyloric area. A suture repair, omentoplasty and lavage of the cavity was performed.
Results: No conversion to open surgery or additional trocars were necessary. Total operative time was 108 minutes and laparoscopic time 86 minutes. Final umbilical incision length was 15 mm. The patient’s pain medication could be kept low and the patient was allowed to be discharged on 5^th postoperative day. After 6 months, the patient was well with no visible umbilical scar.
Conclusion: Transumbilical SAL can be proposed in selected patients for suspicion of perforated gastric ulcer, with the main advantage of cosmetic result.

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Session Number: VidTV1 – Video Channel Rotation Day 1
Program Number: V077