Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis

• Published in: Wideochirurgia i inne techniki mało inwazyjne 2014-03, Vol.9 (2), p.282-285
• Main Authors: Dostalik, Jan, Gunkova, Petra, Gunka, Igor, Mazur, Miloslav, Mrazek, Tomas
• Format: Article
• Language: English
• Subjects: Case Report
• ISSN: 1895-4588; 2299-0054; 2299-0054
• DOI: 10.5114/wiitm.2014.41622

Although natural orifice specimen extraction is now relatively widely performed, there have been no reports on gastric resection with specimen extraction through the transgastric route for peptic ulcer disease. A hybrid technique of the laparoscopic and endoscopic approach is presented in the case of a 58-year old male patient. Preoperative gastric fibroscopy showed postulcer pyloric and antral stenosis. Laparoscopic exploration confirmed gastric enlargement. Laparoscopic two-thirds gastrectomy was performed. The staple line suture of the residual stomach was excised and the specimen was extracted through the esophagus and mouth with a gastroscope. Finally, the residual stomach was closed again using linear endostaplers. Reconstruction was performed according to the Roux-en-Y method. Gastric resection using natural orifice specimen extraction (NOSE) may be a feasible operative procedure. The NOSE with the combination of standard laparoscopy and specimen extraction through a natural orifice can be considered as a bridge to natural orifice translumenal endoscopic surgery.