Saeed Alshlwi1, Aly Elbahrawy1, Hussam Alamri1, Sara Najmeh1, Rajesh Aggarwal1, Sebastian Demyttenaere1, Olivier Court1, Amin Andalib2,3. 1. Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada. 2. Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada. amin.andalib@mcgill.ca. 3. McGill University Health Center, Montreal General Hospital, 1650 Cedar Avenue; Rm: E16-165A, Montreal, QC, H3G 1A4, Canada. amin.andalib@mcgill.ca.
Abstract
BACKGROUND: Over the past two decades, there has been a significant rise in bariatric surgery. As a consequence, the prevalence of obese patients with a combined gastric pathology such as a submucosal tumor (SMT) requiring excision at the same time as bariatric surgery is higher but the management remains controversial. We report the safety and effectiveness of a simultaneous laparoscopic transgastric resection of a large gastric SMT near the esophagogastric junction (EGJ) with sleeve gastrectomy (SG). METHODS: We present a video report of a 52-year-old male (BMI = 49 kg/m2) referred for bariatric surgery, who was found to have a large SMT 2 cm from the EGJ on the lesser curvature on previous gastroscopy. RESULTS: Using five ports placed for laparoscopic SG, the gastric SMT was localized through an anterior gastrotomy and fully excised using a linear stapler and the gastrotomy site was closed. SG was then performed over a 54Fr bougie, including the gastrotomy suture closure. CONCLUSIONS: Several factors play important roles in deciding the best surgical approach for patients who are candidates for bariatric surgery and have concomitant gastric SMTs. This video report describes a safe and effective technique of simultaneous transgastric resection of a lesser curvature gastric SMT near the EGJ in a patient undergoing SG.
BACKGROUND: Over the past two decades, there has been a significant rise in bariatric surgery. As a consequence, the prevalence of obesepatients with a combined gastric pathology such as a submucosal tumor (SMT) requiring excision at the same time as bariatric surgery is higher but the management remains controversial. We report the safety and effectiveness of a simultaneous laparoscopic transgastric resection of a large gastric SMT near the esophagogastric junction (EGJ) with sleeve gastrectomy (SG). METHODS: We present a video report of a 52-year-old male (BMI = 49 kg/m2) referred for bariatric surgery, who was found to have a large SMT 2 cm from the EGJ on the lesser curvature on previous gastroscopy. RESULTS: Using five ports placed for laparoscopic SG, the gastric SMT was localized through an anterior gastrotomy and fully excised using a linear stapler and the gastrotomy site was closed. SG was then performed over a 54Fr bougie, including the gastrotomy suture closure. CONCLUSIONS: Several factors play important roles in deciding the best surgical approach for patients who are candidates for bariatric surgery and have concomitant gastric SMTs. This video report describes a safe and effective technique of simultaneous transgastric resection of a lesser curvature gastric SMT near the EGJ in a patient undergoing SG.
Authors: René Berindoague; Eduard M Targarona; Xavier Feliu; Vicenç Artigas; Carmen Balagué; Aurora Aldeano; Antonio Lahoud; Jordi Navines; Enrique Fernandez-Sallent; Manuel Trias Journal: Surg Innov Date: 2006-12 Impact factor: 2.058
Authors: Ninh T Nguyen; Caitlin Shapiro; Hossein Massomi; Kelly Laugenour; Christian Elliott; Michael J Stamos Journal: Am Surg Date: 2011-10 Impact factor: 0.688