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Transumbilical single-incision laparoscopic wedge resection for gastric submucosal tumors: technical challenges encountered in initial experience.

Park JY, Eom BW, Yoon H, Ryu KW, Kim YW, Lee JH - J Gastric Cancer (2012)

Bottom Line: 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.This technique provides favorable cosmetic results, and also short hospital stay and low morbidity, in carefully selected candidates.

View Article: PubMed Central - PubMed

Affiliation: Gastric Cancer Branch, National Cancer Center, Goyang, Korea.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Home-made single-port device was made from small wound protractor and a surgical glove with conventional laparoscopic trocars.
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Figure 1: Home-made single-port device was made from small wound protractor and a surgical glove with conventional laparoscopic trocars.

Mentions: A 3 to 4 cm-long single vertical incision was made in the umbilicus, and access to the peritoneal cavity was achieved via an open technique. Then, the two surgeons used different types of platforms to introduce laparoscopic instruments into the abdominal cavity through a single incision. One surgeon used a homemade single-port device composed of a small wound protractor (Alexis®, Applied Medical, Rancho Santa Margarita, CA, USA) and a surgical glove for 4 patients (Fig. 1), and the other used the commercially available OCTO-port (DalimSurgNet, Seoul, Korea) or SILS™ port (Covidien, Mansfield, MA, USA) for the remaining 6 patients. A rigid 10 mm laparoscope of 30 degrees and conventional laparoscopic instruments with additional articulating instruments were used to optimize the range of motion.


Transumbilical single-incision laparoscopic wedge resection for gastric submucosal tumors: technical challenges encountered in initial experience.

Park JY, Eom BW, Yoon H, Ryu KW, Kim YW, Lee JH - J Gastric Cancer (2012)

Home-made single-port device was made from small wound protractor and a surgical glove with conventional laparoscopic trocars.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473224&req=5

Figure 1: Home-made single-port device was made from small wound protractor and a surgical glove with conventional laparoscopic trocars.
Mentions: A 3 to 4 cm-long single vertical incision was made in the umbilicus, and access to the peritoneal cavity was achieved via an open technique. Then, the two surgeons used different types of platforms to introduce laparoscopic instruments into the abdominal cavity through a single incision. One surgeon used a homemade single-port device composed of a small wound protractor (Alexis®, Applied Medical, Rancho Santa Margarita, CA, USA) and a surgical glove for 4 patients (Fig. 1), and the other used the commercially available OCTO-port (DalimSurgNet, Seoul, Korea) or SILS™ port (Covidien, Mansfield, MA, USA) for the remaining 6 patients. A rigid 10 mm laparoscope of 30 degrees and conventional laparoscopic instruments with additional articulating instruments were used to optimize the range of motion.

Bottom Line: 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.This technique provides favorable cosmetic results, and also short hospital stay and low morbidity, in carefully selected candidates.

View Article: PubMed Central - PubMed

Affiliation: Gastric Cancer Branch, National Cancer Center, Goyang, Korea.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus