title: Laparoscopic Intragastric Resection: An Alternative Technique for Minimally Invasive Treatment of Gastric Submucosal Tumors.
abstract: To present the technique for and early results of laparoscopic intragastric resection (LIGR).
  
  
  
  Treatment of confirmed or suspected submucosal gastric malignancies relies on clear margin resection, for which minimally invasive surgery is widely accepted. However, resection in some localization remains challenging.
  
  
  
  We present the steps of LIGR for gastric submucosal tumors (GSMTs). We report the results of LIGR in consecutive patients operated at 2 institutions, including intraoperative, pathologic, 30-day major morbidity and mortality characteristics.
  
  
  
  After laparoscopic access to the abdominal cavity, cuffed gastric ports are placed to approximate the anterior gastric wall to the abdominal wall. A pneumogastrum is created. The tumor is resected in the submucosal plane and the deficit closed with intragastric suturing. Specimen extraction is performed perorally or through a gastrotomy site. In 8 proximal intraluminal GSMTs with median size of 3.1 cm (range: 1.8-6.0 cm), median operative time was 167.5 minutes (range: 120-300 mins). There was no major morbidity and no mortality. All resections were R0.
  
  
  
  We illustrate the technique of a novel, feasible, and safe minimally invasive approach to GSMTs. LIGR is an alternative to resect challenging GSMTs by limiting surgical invasiveness and preserving gastrointestinal function.
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Cindy
authors.initials: C
authors.lastname: Boulanger-Gobeil
authors.affiliation: Department of Surgery, Université Laval, Québec City, Québec Canada.|Division of General Surgery, Center Hospitalier Universitaire de Québec, Québec City, Québec, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Gagné
authors.affiliation: Department of Surgery, Université Laval, Québec City, Québec Canada.|Division of General Surgery, Center Hospitalier Universitaire de Québec, Québec City, Québec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Julien
authors.affiliation: Department of Surgery, Université Laval, Québec City, Québec Canada.
authors.forename: Valérie
authors.initials: V
authors.lastname: Courval
authors.affiliation: Division of General Surgery, Odette Cancer Center - Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
authors.forename: Kaitlyn
authors.initials: K
authors.lastname: Beyfuss
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.|Division of General Surgery, Odette Cancer Center - Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
authors.forename: Shady
authors.initials: S
authors.lastname: Ashamalla
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.|Division of General Surgery, Odette Cancer Center - Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Hallet
mesh_terms: D000328:Adult; D000368:Aged; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D005753:Gastric Mucosa / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome