Laparoscopic Transgastric Resection of a Gastric Submucosal Tumor near Esophagogastric Junction with Concomitant Sleeve Gastrectomy: a Video Case Report.
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).



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.



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.



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.
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada.
Saeed
S
Alshlwi
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada.
Aly
A
Elbahrawy
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada.
Hussam
H
Alamri
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada.
Sara
S
Najmeh
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada.
Rajesh
R
Aggarwal
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada.
Sebastian
S
Demyttenaere
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada.
Olivier
O
Court
Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada. amin.andalib@mcgill.ca.|McGill University Health Center, Montreal General Hospital, 1650 Cedar Avenue; Rm: E16-165A, Montreal, QC, H3G 1A4, Canada. amin.andalib@mcgill.ca.
Amin
A
Andalib
D004943:Esophagogastric Junction / Q000601:surgery*; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery
Bariatric surgery; GIST; Leiomyoma; Morbid obesity; Sleeve gastrectomy; Submucosal tumor