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Laparoscopic transhiatal resection of giant esophageal leiomyoma

Epublication WebSurg.com, Jan 2015;15(01). URL: http://websurg.com/doi/vd01en4424

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  • 2015-01-15
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This is the case of a 36-year-old male patient who had slowly progressing symptoms for 10 years. These symptoms were the following: hiccups, progressive dysphagia, first for solids, and then for liquids, and gastro-esophageal reflux. In 2003, the patient was first evaluated in a private clinic and diagnosed with esophageal wall hernia. In 2010, his symptoms were still present and he was evaluated by a physician who performed a new endoscopy, which demonstrated a 90% obstruction of the esophageal lumen. A biopsy was also performed. It was negative for malignancy, hence providing the diagnosis of esophageal leiomyoma. In December 2011, a CT-scan and endoscopic ultrasound were performed leading to the conclusion of an esophageal leiomyoma. A laparoscopic transhiatal resection of the esophageal leiomyoma was decided upon in July 2012. This case is essential because it shows the usefulness of a hook clamp to facilitate traction of the leiomyoma. Additionally, it shows an intraoperative complication consisting in a perforation of the esophageal mucosa, which was sutured by means of Vicryl 4/0.