Innovative Treatment for Early Gastric Cancer, Laparoscopic Wedge Resection of the Stomach Using the Lesion Lifting Method Masahiro Ohgami 1 , Koichro Kumai 1 , Go Wakabayashi 1 , Yoshihide Otani 1 , Masaki Kitajima 1 1Department of Surgery, Keio University Keyword: 胃癌 , 早期胃癌 , 自動縫合器 , 腹腔鏡下手術 , 腹腔鏡下胃局所切除術 pp.1461-1468
Published Date 1993/12/25
DOI https://doi.org/10.11477/mf.1403106349
  • Abstract
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 Four patients with mucosal gastric cancer were successfully treated by laparoscopic wedge resection of the stomach.

 The entire surgical procedure was performed laparoscopically with guidance of intraoperative gastroscopic examination. The gastric wall around the cancerous lesion was exposed. The abdominal wall and the gastric wall in the vicinity of the cancerous lesion were pierced by a 12 G angiocatheter. A small metal rod which was tied with a fine wire at the center was introduced into the stomach through the outer sheath of the catheter. Finally, the lesion was lifted with support of the metal rod (lesion lifting method). Wedge resection was carried out using a endoscopic multifire stapler, an Endo GIA (US Surgical) with a sufficient distance from the metal rod.

 The postoperative course was uneventful in all patients. They were discharged within eight days.

 The resected specimen was 50~60 mm in diameter, and there was enough distance from the lesion to any surgical margin (more than 6 mm). Histological examination revealed that the cancerous infiltration was limited within the mucosal layer in all patients.

 If patients are selected appropriately, this method can be a radical and minimally invasive therapy for early gastric cancer.

Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.


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