Single-port for laparoscopic gastric resection with a novel platform

Abstract

IntroductionLaparoscopic gastrointestinal resections using single-port are possible, but triangulation problems and the need of articulated instruments difficult the procedures.AimTo present a surgical alternative using single-port laparoscopic device on gastric resection.TechniqueThe patient is placed in a supine and reverse Trendelenburg position with surgeon between patient's legs. First assistant was on the right side of the patient with the monitor placed on the patient's cranial side. With the patient under general anesthesia, a transumbilical 3 cm skin incision is performed. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector is introduced through this incision. Three 5-12 mm operating ports were introduced through the single-port device. Due to the gel cap and sleeves, no articulated instruments are necessary. CO2 pneumoperitoneum is established at 12 mmHg. A rigid 30 degree 10 mm laparoscope is introduced. Operation begins with access to the lesser sac by opening the omentum along the greater curvature of the stomach using harmonic scalpel. Once the stomach is fully exposed and a stay suture is place around the tumor. Gastric wall is divided with cautery 1 cm away from the tumor. Tumor is excised. Gastric wall is sutured with two-layer running suture. No drain was used. Umbilical incision was closed.ResultsThis procedure was used in one patient with gastric duplication. Operative time was 200 minutes. Blood loss was minimal. Recovery was uneventful and patient discharged on postoperative day 2. Final aspect of the umbilical incision was good.ConclusionsGastric resection with single-port laparoscopic platform is feasible and may be safely performed in selected patients.

Robot-assisted resection of gastric duplication cysts in a child: a detailed case report

“…These can be achieved through an open or a minimally invasive approach. 7 Nineteen patients with GDCs treated by a laparoscopic approach have been reported in the pediatric literature up to now (Table 1). [1][2][3][8][9][10][11][12][13][14] Three cases had a prenatal diagnosis and more than two-thirds were symptomatic.…”

Laparoscopic resection of gastric duplication cysts in newborns: a report of five cases

“…Machado et al [ 7 ] first reported laparoscopic resection of gastric duplication, followed by Tayar et al [ 8 – 11 ]. However, laparoscopic resection of gastric duplication cysts in newbrons is rarely reported.…”