title: Single-incision laparoscopic gastric resection for submucosal tumors: report of three cases.
abstract: Between March and April 2009, three consecutive patients underwent single-incision laparoscopic gastric wedge resection for a submucosal tumor located in the anterior wall or greater curvature of the stomach. First, we placed two or three trocars through the same infra-umbilical skin incision. Then, we either elevated the tumor with a mini-loop retractor or retracted the gastric wall near the tumor with a laparoscopic grasper. Finally, we resected the tumor using an endoscopic linear stapler. Single-incision laparoscopic gastric resection was successfully completed in all three patients without the need for any extraumbilical skin incisions or conversion to conventional laparoscopic procedures. There was no morbidity. The mean operating time and blood loss were 86 min and 4 ml, respectively, and the mean tumor size and surgical margin were 34 mm and 8 mm, respectively. Histopathologically, two tumors were diagnosed as gastrointestinal stromal tumors and one as a carcinoid tumor. Thus, single-incision laparoscopic gastric resection for submucosal tumors is safe and feasible when performed by experienced laparoscopic surgeons using conventional laparoscopic instruments.
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Koeda
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Toru
authors.initials: T
authors.lastname: Obuchi
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Baba
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D005743:Gastrectomy; D005753:Gastric Mucosa; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*