Hybrid approach with laparoscopic wall‐inversion surgery and single‐incision intragastric surgery for intraluminal gastrointestinal stromal tumor: A case report

• Published in: Asian journal of endoscopic surgery 2021-10, Vol.14 (4), p.794-797
• Main Authors: Kusunoki, Chikako, Hamakawa, Takuya, Nishikawa, Kazuhiro, Sato, Hiromichi, Imamura, Sayumi, Miyahara, Satoru, Sakano, Yu, Miyazaki, Hazuki, Seto, Hiroto, Ueda, Ryuta, Toshiyama, Reishi, Miyo, Masaaki, Takahashi, Yusuke, Sakai, Kenji, Miyake, Masakazu, Miyamoto, Atsushi, Kato, Takeshi, Mori, Kiyoshi, Hirao, Motohiro
• Format: Article
• Language: English
• Subjects: Case reports; Gastrointestinal cancer; gastrointestinal stromal tumor (GIST); Gastrointestinal surgery; laparoscopic wall‐inversion surgery; Laparoscopy; single‐incision intragastric surgery (SIIGS); Tumors
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.12927

Laparoscopic wedge resection (LWR) for intraluminal gastrointestinal stromal tumor (GIST) leads to excessive resection of normal gastric wall. We report a case of GIST around the cardia successfully treated with full‐thickness partial resection using a hybrid approach of laparoscopic surgery and single‐incision intragastric surgery (SIIGS). A 69‐year‐old woman had a 5 cm intraluminal GIST at the posterior wall around the cardia. Submucosal injection of glycerin and indigo carmine was performed with transoral endoscopy. Circumferential seromuscular incision followed by placement of seromuscular sutures to invert the lesion into the stomach was performed under laparoscopy. By SIIGS, resection of the inverted mucosa and retrieval of the tumor were completed. A hybrid approach consisting of laparoscopic wall‐inversion surgery and SIIGS was useful for intraluminal GIST and may expand the indications for laparoscopic wall‐inversion surgery by removing size limitations.