title: Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis.
abstract: Although natural orifice specimen extraction is now relatively widely performed, there have been no reports on gastric resection with specimen extraction through the transgastric route for peptic ulcer disease. A hybrid technique of the laparoscopic and endoscopic approach is presented in the case of a 58-year old male patient. Preoperative gastric fibroscopy showed postulcer pyloric and antral stenosis. Laparoscopic exploration confirmed gastric enlargement. Laparoscopic two-thirds gastrectomy was performed. The staple line suture of the residual stomach was excised and the specimen was extracted through the esophagus and mouth with a gastroscope. Finally, the residual stomach was closed again using linear endostaplers. Reconstruction was performed according to the Roux-en-Y method. Gastric resection using natural orifice specimen extraction (NOSE) may be a feasible operative procedure. The NOSE with the combination of standard laparoscopy and specimen extraction through a natural orifice can be considered as a bridge to natural orifice translumenal endoscopic surgery.
authors.affiliation: Department of Surgery, Municipal Hospital Ostrava Fifejdy, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Dostalik
authors.affiliation: Department of Surgery, University Hospital Ostrava, Czech Republic ; Department of Surgery, Faculty of Medicine, University of Ostrava, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Gunkova
authors.affiliation: Department of Surgery, University Hospital Hradec Kralove, Czech Republic.
authors.forename: Igor
authors.initials: I
authors.lastname: Gunka
authors.affiliation: Department of Surgery, University Hospital Ostrava, Czech Republic ; Department of Surgery, Faculty of Medicine, University of Ostrava, Czech Republic.
authors.forename: Miloslav
authors.initials: M
authors.lastname: Mazur
authors.affiliation: Department of Surgery, Municipal Hospital Ostrava Fifejdy, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Mrazek
keywords: gastric resection; laparoscopy; natural orifice specimen extraction
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