“LAPAROSCOPIC INTRAGASTRIC EXCISION OF POSTERIORLY LOCATED GASTRIC GIST USING CONVENTIONAL LAPAROSCOPIC INSTRUMENTS – A CASE REPORT”

2021 ◽  
pp. 29-31
Author(s):  
Kulwant Singh Bhau ◽  
Iqbal Saleem Mir ◽  
Mufti Mahmood Ahmad

Background: Gastro-intestinal stromal tumour (GIST) commonly involves stomach. Recently there has been an inclination towards managing these benign but potentially malignant lesions by minimal invasive techniques. Surgical excision of gastric GIST mostly requires anterior wall gastrostomy especially for intraluminal lesions. The size and location of the lesion are critical from technical point of view. Lesions located at gastro-esophageal junction requires larger anterior gastric wall opening to reach the site of tumour for excision. Endoscopic excision for such lesions is not always amenable. We performed excision of a posteriorly locat Methods: ed gastric GIST at GE junction by hitching the anterior gastric wall with the anterior abdominal wall and by directly creating pneumogastrium percutaneously for placing three intra-gastric trocars. Results: Patient was discharged on post-operative day 3 in a satisfactory condition. Histopathology revealed complete resection of GIST lesion with margins free from tumour. Immuno-histochemistry (IHC) conrmed it to be GIST with low malignant potential and patient was advised regular follow up. Laparoscopic intra-gastric excision of a posteriorly located gast Conclusion: ro-oesophageal junction GIST lesion after creating pneumogastrium and using conventional laparoscopic instruments is a safe procedure

2007 ◽  
Vol 17 (10) ◽  
pp. 1340-1345 ◽  
Author(s):  
Pedro E. B. Fusco ◽  
Renato S. Poggetti ◽  
Riad N. Younes ◽  
Belchor Fontes ◽  
Dario Birolini

Author(s):  
Emmanuel Conrado SOUZA

Background: Until the early 1980s, Stamm technique was considered standard method to gastrostomy. After description of the endoscopic technique, due to its efficiency and speed, quickly became the method of choice for long-term enteral access. Aim: Describe a technique that combines direct view of the stomach from open surgery with the simplicity and less traumatic endoscopic gastrostomy method. Method: In patient supine under spinal anesthesia the technique stars with small epigastric incision to pull up the stomach. A 3 mm incision in the left hypochondrium is made to pass needle puncture to guidewire passage. The stomach is drilled, guidewire is seizured, connection to catheter and percutaneous approach is made with traction of the stomach to the abdominal wall. Purse suture on the anterior gastric wall is not needed. Results: Twenty-eight patients underwent gastrostomy using endoscopy devices; six had local minor complications without the need for re-intervention; there was no death. Conclusion: The surgical gastrostomy with minimal incision in the stomach to pull off the catheter using endoscopic gastrostomy devices, proved to be safe, easy to perform, less traumatic, quick, simple and elegant.


2019 ◽  
Vol 224 ◽  
pp. 172-178 ◽  
Author(s):  
T. Neubauer ◽  
M. Plecko ◽  
S. Grechenig ◽  
A. Hartmann ◽  
R. Ortmaier ◽  
...  

2007 ◽  
Vol 148 (4) ◽  
pp. 161-164 ◽  
Author(s):  
Péter Lukovich ◽  
Balázs Kádár ◽  
Attila Jónás ◽  
Mehdi Sadatakhavi ◽  
Gábor Váradi ◽  
...  

Introduction: In the last few years the rapid development of flexible endoscopies has opened new possibilities in minimal invasive procedures. With the help of these techniques the exposure, the risk of complications and the healing period of the patient might be reduced. One of these procedures is the transgastric intervention. Through an incision on the wall of the stomach, the endoscope could be led into the abdominal cavity, where several interventions can be performed. The aim of the study was to examine the technical feasibility and the success of the formation of gastro-jejunal anastomosis. Meanwhile the difficulties of the method could be explored in order to introduce this method in human use. Method: A lifelike biosynthetic model was made from a slaughtered domestic pig’s gastrointestinal tract (stomach and the first few jejunum loops) which was fixed onto a plastic frame. Two single-channel gastroscopes were inserted into the stomach. On the wall of the stomach an approximately 2 centimetres wide incision was made by the electrocoagulator with a needle-knife. Through it the first jejunum loop was grasped by a foreign-body forceps and then was retracted into the stomach. Subsequently the jejunum loop was held safely with the first endoscope. Parallel to it an incision was made on the jejunum by the electrocoagulator. The authors managed to securely unite the open edges of the gastric wall and the jejunum with endoclips. Result: The model was good for practising. The anastomosis is technically feasible and was successfully made on biosynthetic porcine model using the transgastric route. Although the incisions both on the gastric wall and on the jejunum loop were made easily, the fixing of the anastomosis might be questionable. Conclusion: It was revealed that more experiments and the development of new, special instruments are needed in order to conduct the anastomosis safely.


2019 ◽  
Vol 38 (6) ◽  
pp. 1359-1368 ◽  
Author(s):  
Dominique Engel ◽  
Marc A. Furrer ◽  
Patrick Y. Wuethrich ◽  
Lukas M. Löffel

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