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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

Photograph of the abdomen taken 1 month after the operation shows excellent cosmesis with minimal scar.
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Figure 3: Photograph of the abdomen taken 1 month after the operation shows excellent cosmesis with minimal scar.

Mentions: The perioperative results in our patients were thought to be comparable to those in the previously reported laparoscopic series.(15,16) The cosmetic outcomes after SILS were excellent as the only single incision made stayed hidden inside the umbilicus (Fig. 3). Generally, the length of postoperative hospital stay is considered as a parameter of invasiveness of surgery.(19) The mean hospital stay after SILS gastric wedge resection was 5 days, which is acceptable and even shorter than that seen after conventional laparoscopic surgery. These results suggest that SILS procedure can provide patients with the following benefits: better cosmesis, less postoperative pain, fewer postoperative morbidities, and shorter convalescence. This also satisfies a growing demand for less-invasive surgical procedures. Moreover, SILS can be performed with conventional laparoscopic instruments and skills, with little modification.


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)

Photograph of the abdomen taken 1 month after the operation shows excellent cosmesis with minimal scar.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Photograph of the abdomen taken 1 month after the operation shows excellent cosmesis with minimal scar.
Mentions: The perioperative results in our patients were thought to be comparable to those in the previously reported laparoscopic series.(15,16) The cosmetic outcomes after SILS were excellent as the only single incision made stayed hidden inside the umbilicus (Fig. 3). Generally, the length of postoperative hospital stay is considered as a parameter of invasiveness of surgery.(19) The mean hospital stay after SILS gastric wedge resection was 5 days, which is acceptable and even shorter than that seen after conventional laparoscopic surgery. These results suggest that SILS procedure can provide patients with the following benefits: better cosmesis, less postoperative pain, fewer postoperative morbidities, and shorter convalescence. This also satisfies a growing demand for less-invasive surgical procedures. Moreover, SILS can be performed with conventional laparoscopic instruments and skills, with little modification.

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