Laparoscopic Endogastric Resection of Endoluminal Tumors: Technique and Variations

Edmund W. Lee, MD; Patrick J. Worth, MD; Brendan C. Visser, MD, FACS

Product Details
Product ID: ACS-5587
Year Produced: 2018
Length: 8 min.


Laparoscopic endogastric resection of endoluminal tumors is described in the literature mostly as case studies and case series. This video aims to show and describe this technique. Patient selection with this surgery depends on the location, histology, and morphology of the tumor. For example, patients with a low-grade endophytic tumor located in the fundus qualify for this minimally-invasive resection. Firstly, we mobilize the posterior wall of the stomach. This allows for adequate manipulation of the tumor in the endogastric space. The stomach is then insufflated with an endoscope, creating enough tension to insert radially-dilating laparoscopic trocars into the stomach. Typically, we use one 5mm camera port along with 5mm and 12mm working ports. Sutures or a loop ligature are used as anchors to pull traction and exposure for the Endo-GIA stapler. Smaller tumors could be retrieved from the oral cavity, which would sometimes mitigate the need to create a larger gastrotomy to retrieve the tumor. Alternatively, we have used a two-port technique: a 5mm camera port and a 12mm working port. The 12mm working port could house multiple instruments in parallel, such as a loop ligature and a grasper. If lateral traction is inadequate, we use the endoscope as our 'camera port,' freeing the 5mm trocar for another instrument. We hope that this educational video will allow more centers to utilize technique, paving the way for more robust outcomes data.