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Case Reports
. 2014 Jun;9(2):282-5.
doi: 10.5114/wiitm.2014.41622. Epub 2014 Mar 31.

Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis

Jan Dostalik  1 , Petra Gunkova  2 , Igor Gunka  3 , Miloslav Mazur  2 , Tomas Mrazek  1
Affiliations
Case Reports

Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis

Jan Dostalik et al. Wideochir Inne Tech Maloinwazyjne. 2014 Jun.

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.

Keywords: gastric resection; laparoscopy; natural orifice specimen extraction.

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Figures

Photo 1
Photo 1
Insertion of the specimen into the stump of the stomach
Photo 2
Photo 2
Extraction of the specimen
See this image and copyright information in PMC

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