Robotic Resection of Difficult to Access Gastric Gastrointestinal Stromal Tumors (GISTs): Proximal Lesser Curvature

Megan Harper, MD

Product Details
Product ID: ACS-6064
Year Produced: 2020
Length: 6 min.


Robotic surgery provides an ergonomic benefit to access gastric gastrointestinal stromal tumors (GISTs) that are not amenable to standard wedge resection via laparoscopic or open techniques. We demonstrate robotic resection of an exophytic lesser curve gastric GIST in a 45yo female who presented with nausea, weight loss, right upper quadrant and epigastric pain. Ultrasound was concerning for a lesser sac mass; CT delineated an enhancing mural mass adjacent to the proximal lesser curvature of the stomach. Full staging imaging showed no metastatic disease. Altogether, this was consistent with gastric GIST. We planned local resection with partial gastrectomy and 1cm negative margins. We applied a robotic approach to enhance visualization and ergonomics given the difficult location on the proximal lesser curvature. Given improved access to this area and ease of robotic suturing, we were able to provide a less radical resection (local resection as opposed to total gastrectomy), which led to improved functional outcome and expedited recovery (length of stay 3 days). Repeat post-operative imaging at 9 months demonstrated no residual tumor or stricture at repair site. The patient has not had symptoms of delayed gastric emptying nor early satiety.