• Title/Summary/Keyword: gastric incision

Search Result 34, Processing Time 0.023 seconds

Transumbilical Single-Incision Laparoscopic Wedge Resection for Gastric Submucosal Tumors: Technical Challenges Encountered in Initial Experience

  • Park, Ji Yeon;Eom, Bang Wool;Yoon, Hongman;Ryu, Keun Won;Kim, Young-Woo;Lee, Jun Ho
    • Journal of Gastric Cancer
    • /
    • v.12 no.3
    • /
    • pp.173-178
    • /
    • 2012
  • Purpose: To report the initial clinical experience with single-incision laparoscopic gastric wedge resection for submucosal tumors. Materials and Methods: The medical records of 10 patients who underwent single-incision laparoscopic gastric wedge resection between July 2009 and March 2011 were reviewed retrospectively. The demographic data, clinicopathologic and surgical outcomes were assessed. Results: The mean tumor size was 2.5 cm (range, 1.2~5.0 cm), and the tumors were mostly located on the anterior wall (4/10) or along the greater curvature (4/10), of the stomach. Nine of ten procedures were performed successfully, without the use of additional trocars, or conversion to laparotomy. One patient underwent conversion to multiport laparoscopic surgery, to get simultaneous cholecystectomy safely. The mean operating time was 66.5 minutes (range, 24~132 minutes), and the mean postoperative hospital stay was 5 days (range, 4~7 days). No serious perioperative complications were observed. Of the 10 submucosal tumors, the final pathologic report revealed 5 gastrointestinal stromal tumors, 4 schwannomas, and 1 heterotopic pancreas. Conclusions: Single-incision laparoscopic gastric wedge resection for gastric submucosal tumors is feasible and safe, when performed by experienced laparoscopic surgeons. This technique provides favorable cosmetic results, and also short hospital stay and low morbidity, in carefully selected candidates.

Single-incision Laparoscopic Gastrectomy for Gastric Cancer

  • Lee, Yoontaek;Kim, Hyung-Ho
    • Journal of Gastric Cancer
    • /
    • v.17 no.3
    • /
    • pp.193-203
    • /
    • 2017
  • The implementation of national cancer screening has increased the detection rates of early gastric cancer (EGC) in Korea. Since the successful introduction of laparoscopic gastrectomy for gastric cancer in the early 1990s, this technique has demonstrated improved short-term outcomes without compromising long-term oncologic results. It is associated with reduced pain, shorter hospitalization, reduced morbidity rates, better cosmetic outcomes, and equivalent mortality rates as those for open surgery. Laparoscopic gastrectomy improves patients' quality of life (QOL) and provides favorable prognosis. Single-incision laparoscopic gastrectomy (SILG) is one extremely minimally invasive method, theoretically offering improved cosmetic results, less postoperative pain, and earlier recovery after surgery than conventional multiport laparoscopic gastrectomy. In this context, SILG is thought to be an optimal method to promote and maximize patients' QOL in the acute postoperative phase. However, the technical difficulties of this procedure have limited its use. Since the first report describing single-incision distal gastrectomy in 2011, only 16 studies to date have evaluated SILG. Most of these studies have focused on the technical feasibility and safety of SILG because its long-term outcomes have not been reported. This article reviews the advantages and limitations of SILG.

Convenience of Adding a Needle Grasper in Single-Incision Laparoscopic Distal Gastrectomy With Billroth I Anastomosis for Clinical Early Gastric Cancer

  • Kim, Jong Won;Park, Joong-Min;Chi, Kyong-Choun
    • Journal of Gastric Cancer
    • /
    • v.22 no.3
    • /
    • pp.248-259
    • /
    • 2022
  • Purpose: To overcome the technical difficulties of single-incision laparoscopic distal gastrectomy (SILDG), needle grasper (Endo ReliefTM)-assisted SILDG (NASILDG) was developed. Here, we compared the operative convenience and postoperative outcomes between SILDG and NASILDG. Materials and Methods: A needle grasper was inserted into the right upper abdomen and used in the NASILDG. We retrospectively reviewed patients who underwent D1 + dissection and delta-shaped Billroth I anastomosis with SILDG or NASILDG performed by a single surgeon between September 2015 and August 2018. Results: The SILDG (male, 50.0%) and NASILDG (male, 60.0%) groups included 10 and 15 patients, respectively. The operative time without combined operation and anastomosis was significantly shorter in the NASILDG group. Early complications and scar characteristics were not significantly different between the two groups. Conclusions: By adding a needle grasper, SILDG became more convenient without decreasing cosmetic results. NASILDG could be a recommended method to reduce the technical difficulty of SILDG.

Laparoscopic Removal of a Gastric Trichobezoar in an 8-Year-Old Girl - a Case Report -

  • Choi, Gyu-Seog;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
    • /
    • v.16 no.1
    • /
    • pp.43-48
    • /
    • 2010
  • Gastric trichobezoars are commonly observed in young women with trichotillomania and trichophagia. We encountered an 8-year-old girl who had trichotillomania and trichophagia with abdominal pain and a mass, which was diagnosed as a large gastric trichobezoar. On physical examination, a huge, firm nontender mobile mass was palpated in her epigastrium. An upper gastrointestinal series and abdominal computed tomography (CT) scan showed a large mass in the stomach. Endoscopic removal was tried but failed. Laparoscopic removal was therefore performed. The trichobezoar was successfully retrieved through a gastrotomy and removed through an extended umbilical trocar incision. This case demonstrates that laparoscopic removal of large gastric trichobezoars is feasible and safe without a large abdominal incision.

  • PDF

The Single Incision Laparoscopic Intragastric Wedge Resection of Gastric Submucosal Tumor

  • Na, Jin-Uk;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
    • /
    • v.11 no.4
    • /
    • pp.225-229
    • /
    • 2011
  • Purpose: Laparoscopic wedge resection of gastric submucosal tumor may be difficult in case of the endophytic mass or the mass located unreachable area such as cardia, and intragastric approach can be useful. We would present the experiences of the intragastric wedge resection. Materials and Methods: There were 7 patients diagnosed as gastric submucosal tumor and underwent the intragastric wedge resection at Surgery, Chungnam National University Hospital. We reviewed medical record. Results: There were 3 male and 4 female. Mean age was 65 years-old (57~73). Mean body mass index was 26.28 kg/$m^2$ (21.28~35.30). Location of lesions was 4 cardia, 2 fundus and 1 midbody, respectively. Mean operation time was 83.6 minutes (70~105). All patients were healed without any complication. Mean postoperative hospital stay was 5.4 days (4~6). Mean size was 2.7 cm (2.3~3.8). Pathologic finding was 5 gastrointestinal stromal tumor and 2 leiomyoma. Conclusions: The single incision intragastric wedge resection of gastric submucosal tumor is feasible and acceptable, especially in mass of gastric upper part.

Choice of LECS Procedure for Benign and Malignant Gastric Tumors

  • Min, Jae-Seok;Seo, Kyung Won;Jeong, Sang-Ho
    • Journal of Gastric Cancer
    • /
    • v.21 no.2
    • /
    • pp.111-121
    • /
    • 2021
  • Laparoscopic endoscopic cooperative surgery (LECS) refers to the endoscopic dissection of the mucosal or submucosal layers with laparoscopic seromuscular resection. We recommend a treatment algorithm for the LECS procedure for gastric benign tumors according to the protruding type. In the exophytic type, endoscopic-assisted wedge resection can be performed. In the endophytic type, endoscopic-assisted wedge resection of the anterior wall is relatively easy to perform, and endoscopic-assisted transgastric resection, laparoscopic-assisted intragastric surgery, or single-incision intragastric resection in the posterior wall and esophagogastric junction (EG Jx) can be attempted. We propose an algorithm for the LECS procedure for early gastric cancer according to the tumor location. The endoscopic submucosal dissection (ESD) procedure can be adapted for all areas of the stomach, and single-incision ESD can be performed in the mid to high body and the EG Jx. In full-thickness gastric resection, laparoscopy-assisted endoscopic full-thickness resection can be adapted for the entire area of the stomach, but it cannot be applied to the pyloric and EG Jx. In conclusion, surgeons need to select the LECS procedure according to tumor type, tumor location, the surgeon's individual experience, and the situation of the institution while also considering the advantages and disadvantages of each procedure.

Endoscopic Management of Gastric Subepithelial Tumor (위상피하종양의 내시경적 진단 및 치료)

  • Hyunchul Lim
    • Journal of Digestive Cancer Research
    • /
    • v.10 no.1
    • /
    • pp.16-21
    • /
    • 2022
  • Diagnosis of gastric subepithelial tumors (SETs) is sometimes difficult with conventional endoscopy or tissue sampling with standard biopsy, so non-invasive imaging modalities such as endoscopic ultrasound (EUS) and computed tomography are used to evaluate the characteristics of SETs features (size, location, originating layer, echogenicity, shape). However imaging modalities alone is not able to distinguish among all types of SETs, so histology is the gold standard for obtaining the final diagnosis. For tissue sampling, mucosal cutting biopsy and mucosal incision-assisted biopsy and EUS-guided fine-needle aspiration or biopsy (EUS-FNA or EUS-FNB) is commonly recommended. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for resection of SETs involving the mucosal and superficial submucosal layers, could not treat adequately and safely the SETs involving the deep mucosa and muscularis propria. Submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) is used as a therapeutic option for the treatment of SETs with the development of reliable endoscopic closure techniques and tools.

Solo Intracorporeal Esophagojejunostomy Reconstruction Using a Laparoscopic Scope Holder in Single-Port Laparoscopic Total Gastrectomy for Early Gastric Cancer

  • Ahn, Sang-Hoon;Son, Sang-Yong;Jung, Do Hyun;Park, Young Suk;Shin, Dong Joon;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
    • /
    • v.15 no.2
    • /
    • pp.132-138
    • /
    • 2015
  • Single-incision laparoscopic total gastrectomy for gastric cancer has recently been reported by Seoul National University Bundang Hospital. However, this is not a popular procedure primarily because of the technical difficulties involved in achieving consistent intracorporeal esophagojejunostomy. At Seoul National University Bundang Hospital, we recently introduced a simple, easy-to-use, low-profile laparoscopic manual scope holder that enables the maintenance of a stable field of view, the most demanding condition in single-port gastrectomy. In this technical report, we describe in detail the world's first solo single-incision laparoscopic total gastrectomy with D1+ lymph node dissection and intracorporeal esophagojejunostomy for proximal early gastric cancer.

Comparative study of wound healing in canine stomach with CO2 laser and scalpel incisions (CO2 레이저와 scalpel을 이용한 위 절개 시 개에서의 창상 치유 평가)

  • Lee, Jae-Yeon;Hwang, You-Sun;Kim, Han-Kyul;Choi, Hyun-Suk;Jeong, Seong-Mok;Cho, Sung-Whan;Park, Chang-Sik;Kim, Myung-Cheol
    • Korean Journal of Veterinary Research
    • /
    • v.50 no.2
    • /
    • pp.155-160
    • /
    • 2010
  • The objective of this study was to compare wound healing in stomach with $CO_{2}$ laser and scalpel incision by measuring the extent of bleeding, the ease of gastric incision, incision time, degree of adhesion and wound healing degree in dogs. Sixteen healthy dogs were used. Two symmetrical incisions were made in ventral aspect of the stomach between the greater and lesser curvatures were made with scalpel and 0.2 mm spot diameter $CO_{2}$ laser (8W, continuous wave) in sixteen dogs. And then each wound was closed with absorbable suture in a two-layer inverting seromuscular pattern. At 3, 7, 14 and 21 days after initial wounding, each wound was taken for histological observation. On surgery, the extent of bleeding, the ease of incision and incision time showed significant differences between the groups. The $CO_{2}$ laser provided better hemostasis (p < 0.05) and smaller postoperative adhesion compared with the scalpel. However, the scalpel produced faster speed of incision and was easier to handle than the $CO_{2}$ laser (p < 0.05). Although there was no considerable difference between the two groups in histological observation, necrosis and calcium deposit tended to be larger in the $CO_{2}$ laser than in the scalpel.

Laparoscopic Surgery for Removal of the Multiple Large Gastric Bezoars

  • Hong, Tae-Ho;Kim, Jin-Jo;Park, Seung-Man
    • Journal of Gastric Cancer
    • /
    • v.10 no.2
    • /
    • pp.84-86
    • /
    • 2010
  • Bezoars are retained concretions of undigested animal or vegetable material that can produce gastrointestinal obstruction, ulceration, and bleeding. Therapeutic options for gastric bezoars include enzyme therapy (papain, cellulase, or acetylcysteine), endoscopic disruption and removal, and surgical removal. Multiple large gastric bezoars generally require conventional surgical management through an upper abdominal incision. With the recent improvement of laparoscopy, a lot of portions of abdominal operations have been performed laparoscopically. We successfully removed multiple large gastric phytobezoars in a 52-year-old female completely through laparoscopy. This supported the feasibility of laparoscopic surgery for patients with gastric bezoars.