Laparoscopic resection of a huge intraluminal gastric submucosal tumor located in the anterior wall: eversion method.

Although numerous operative approaches have been utilized for gastric submucosal tumors, laparoscopic wedge resection has been regarded as the treatment of choice in recent years. As widespread use of diagnostic endoscopy has exposed a number of gastric submucosal tumors, the laparoscopic wedge resections are being performed with increased frequency. Many reports have been published which describe the technique of laparoscopic wedge resection of gastric submucosal tumors, and by far most of them were about the techniques for masses located at the posterior wall or esophagogastric junction. Generally, wedge resection for tumors on the anterior wall is regarded as an easy procedure especially when the mass is extraluminal mass. However, when the tumor is huge and intraluminal, it is very difficult to resect without compromising the gastric lumen as wedge resection of a huge intraluminal mass in situ inevitably includes a wide portion of normal gastric wall. In this article, we describe a successfully performed laparoscopic wedge resection of a huge intraluminal gastric submucosal tumor while preserving the volume of residual stomach without compromising the gastric lumen using the Eversion method through gastrotomy made with laparoscopic ultrasound guidance. (c) 2005 Wiley-Liss, Inc.