Benign gastric tumors. Minimally invasive approach.

BACKGROUNDS: Historically, major subsets of benign gastric tumors requiring surgical excision have required open laparotomy.

METHODS

We have used laparoscopy to resect lesions in eight such patients. Lesion locations were gastroesophageal junction (one), gastric body (three), and pylorus (four). Four lesions were successfully located by instrument palpation. Six lesions were excised using gastrotomy, eversion of tumor, and resection, followed by stapled gastrotomy closure. The lesion at the posterior GE junction was evaluated through a gastrotomy and resected transgastrically. The two pyloric lesions were removed by laparoscopic distal gastrectomy and gastrojejunostomy.

RESULTS

Procedure times were 55-210 min; oral feeding was instituted on postoperative day 1-5; patients were discharged 1-6 days postoperatively.

CONCLUSIONS

Benign tumors of the stomach may be approached and resected laparoscopically; a transgastric, intra-organ approach is safe and efficient; laparoscopic distal gastrectomy is safe and technically feasible; patients have a shorter recovery interval and shorter postoperative hospital stay. Cautious progress in this field is recommended.