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Review
. 2014 Sep 28;20(36):13035-43.
doi: 10.3748/wjg.v20.i36.13035.

Minimally invasive surgery for submucosal (subepithelial) tumors of the stomach

Chang Min Lee  1 , Hyung-Ho Kim  1
Affiliations
Review

Minimally invasive surgery for submucosal (subepithelial) tumors of the stomach

Chang Min Lee et al. World J Gastroenterol. .

Abstract

Minimally invasive surgery has become common in the surgical resection of gastrointestinal submucosal tumors (SMTs). The purpose of this article is to review recent trends in minimally invasive surgery for gastric SMTs. Although laparoscopic resection has been main stream of minimally invasive surgery for gastrointestinal SMTs, recent advances in endoscopic procedures now provide various treatment modalities for gastric SMTs. Moreover, investigators have developed several hybrid techniques that include the advantages of both laparoscopic and endoscopic procedure. In addition, several types of reduced port surgeries, modification of conventional laparoscopic procedures, have been recently applied to the surgical resection of SMTs. Meanwhile, robotic surgery for SMTs requires further evidence and improvement.

Keywords: Gastrointestinal tract; Minimally invasive; Submucosal tumor; Surgery.

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Figures

Figure 1
Figure 1
Endoscopic submucosal tunnel dissection. A: After the mucosa is lifted by submucosal injection, a 2 cm mucosal incision is made approximately 5 cm proximal to the submucosal tumor (SMT); B: A submucosal tunnel is created using endoscopic submucosal dissection; C: The submucosal dissection is continued until the SMT is visible by endoscopy; D: Dissection is performed along the margin of the SMT with an endoscopic knife; E: The dissected SMT is removed through the mucosal defect.
Figure 2
Figure 2
Laparoscopic endoscopic cooperative surgery. A: Three-fourths of the circumference is cut in the endoscopic side; B: Laparoscopic seromuscular dissection is performed along the submucosal dissection line; C: With the tumor and the non-resected portion are lifted, the defect is closed with laparoscopic linear staplers; D: The direction of stapling should be perpendicular to the longitudinal axis of the stomach.
Figure 3
Figure 3
Non-exposed endoscopic wall-inversion surgery. A: Laparoscopic seromuscular dissection is done after endoscopic submucosal injection. Then, laparoscopic seromuscular suture is performed around the dissected portion; B: Subsequently, the dissected portion is invaginated to the luminal side; C: The mucosal layer is cut with the endoscopic device.
See this image and copyright information in PMC

References

    1. Dubois F, Berthelot G, Levard H. [Cholecystectomy by coelioscopy] Presse Med. 1989;18:980–982. - PubMed
    1. Hwang SH, Park do J, Kim YH, Lee KH, Lee HS, Kim HH, Lee HJ, Yang HK, Lee KU. Laparoscopic surgery for submucosal tumors located at the esophagogastric junction and the prepylorus. Surg Endosc. 2009;23:1980–1987. - PubMed
    1. Tsushimi T, Matsui N, Kurazumi H, Takemoto Y, Oka K, Seyama A, Morita T. Laparoscopic resection of an ileal lipoma: Report of a case. Surg Today. 2006;36:1007–1011. - PubMed
    1. Lin MW, Chen KH, Lin HF, Chen HA, Wu JM, Huang SH. Laparoscopy-assisted resection of ileoileal intussusception caused by intestinal lipoma. J Laparoendosc Adv Surg Tech A. 2007;17:789–792. - PubMed
    1. Ako E, Morisaki T, Hasegawa T, Hirakawa T, Tachimori A, Nakazawa K, Yamagata S, Kanehara I, Nishimura S, Taenaka N. Laparoscopic resection of ileal lipoma diagnosed by multidetector-row computed tomography. Surg Laparosc Endosc Percutan Tech. 2010;20:e226–e229. - PubMed