Laparoscopic gastric stromal tumor

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Laparoscopic gastric stromal tumor

Authors

Mots-clés

stomach,operation,stroma,laparoscopy

Type de vidéo

Vidéo chirurgicale

Durée

04'00''

Publication

2003-05

Popularité

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E-publication

WeBSurg.com, May 2003;3(05).
URL: http://www.websurg.com/doi-vd01en1440e.htm

Laparoscopic gastric stromal tumor

1. Trocar placement and exposure 00'13''

The trocars are positioned as shown: trocar A for the optic, trocars B and C are operating trocars and D and E are retracting trocars. A tape is passed around the round ligament to ensure proper exposure of the gastric area. To attain exposure, a grasper holds the duodenum; this is the pylorus and we can see the mass bulging of the anterior gastric wall.

2. Tumor dissection 01'04''

The anterior gastric wall is exposed with 2 graspers in trocars D and E. This allows the surgeon to open the anterior gastric wall right on the mass. The seromuscular layer is opened using the ultrasonic grasper and care is taken to stay in the seromuscular layer of the gastric wall. The dissection proceeds just below and as the mucosal layer is grasped, it is tented up and opened using the same instrument. We are now inside the cavity of the stomach. The tumor can be seen and using pressure with the 2 graspers, the tumor is expelled into the peritoneal cavity. The mass is spheric and purely submucosal. The pedicle of the tumor is cut using an endoscopic linear stapler.

3. Extraction and closure 02'53''

The spheric tumor is placed in a retrieval sac and the next step is the closure of the wall. The incision of the anterior gastric wall is closed using interrupted extramucosal sutures. An extracorporeal knot-tying technique is being used. The tumor is then exteriorized through the optic trocar. This ends the procedure.