Totally Laparoscopic Transgastric Resection of a Gastric Submucosal Fibrolipoma and Concomitant Sleeve Gastrectomy in a
- PDF / 164,638 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 103 Downloads / 190 Views
MULTIMEDIA ARTICLE
Totally Laparoscopic Transgastric Resection of a Gastric Submucosal Fibrolipoma and Concomitant Sleeve Gastrectomy in a Morbidly Obese Patient Damiano Pennisi 1
&
Marina Troian 1 & Carlo Nagliati 1 & Alessandro Balani 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction To evaluate feasibility and safety of a totally laparoscopic transgastric resection with concomitant sleeve gastrectomy in a morbidly obese presenting with benign lesion located along the lesser gastric curvature. Materials and Methods We report the case of a morbidly obese patient with an incidental submucosal lesion of the lesser curvature radiologically consistent with fibrolipoma at preoperative work-up. Benign nature of the mass was then confirmed EUS-biopsy. Results A combinated laparoscopic transgastric approach was successfully attempted resulting in a complete excision of the submucosal lesion and concomitant sleeve gastrectomy. Intraoperative and definitive histology confirmed the benign nature of the mass. Postoperative course was uneventful. Conclusion Concomitant transgastric resection of submucosal benign lesions during laparoscopic sleeve gastrectomy represents both a safe and feasible surgical approach in morbidly obese patients. Preoperative work-up is of great importance in order to assess the benign nature of the lesion. Keywords Gastric lipoma . Bariatric surgery . Sleeve gastrectomy . Concomitant . Laparoscopy . Transgastric resection . Obesity
Background Incidental diagnosis of benign gastric tumors in the setting of bariatric surgery might raise the need of a concomitant resection. A totally laparoscopic approach appears to be safe and feasible for benign lesions located along the lesser gastric curvature.
subcardial lesser curvature was identified. Subsequent CT scan and EUS with biopsy were suggestive benign fibrolipoma. Patient was then scheduled for laparoscopic sleeve gastrectomy with concomitant transgastric mass resection.
Results Materials and Methods We report the case of a 44-year-old morbidly obese male patient referred for Bariatric Surgery. During routine preoperative workup, a two centimeters submucosal lesion on the Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04832-6) contains supplementary material, which is available to authorized users. * Damiano Pennisi [email protected] 1
Department of Surgery, San Giovanni di Dio Hospital, Via Fatebenefratelli 34, 34170 Gorizia, Italy
After pneumoperitoneum was established, intragastric access was obtained with one 10-mm and two 5-mm gastrotomies along the greater curvature, allowing for operative trocar introduction and stomach insufflation. A clamp placed right after the Treitz ligament prevented for bowel over-insufflation. Using a radiofrequency energy device, mucosal dissection was begun, and the submucosal space entered. Progressive detachment of the lesion from the muscular layer was obtained. Frozen section analysis confirmed be
Data Loading...
