Endoscopy-assisted laparoscopic intragastric resection of early gastric cancer
Epublication WebSurg.com, Jan 2020;20(01). URL: http://websurg.com/doi/vd01en5876
In the minimally invasive approach to a gastric pathology, the association of laparoscopy with endoscopy (also called hybrid or collaborative surgery) emerges as an advanced therapeutic option for the surgical treatment of both benign and malignant intragastric lesions in selected patients. We present the case of an elderly patient aged 86 with a serious medical history. She is endoscopically diagnosed with a gastric lesion located in the incisura angularis with a biopsy of high-grade dysplasia/carcinoma “in situ”. Given the patient's age and her medical history, the multidisciplinary committee decided to perform a minimally invasive surgery. Submucosal dissection of the lesion using a hybrid approach (intragastric endoscopy/laparoscopy) was proposed. The pathological area was marked and stained by endoscopy, followed by intragastric submucosal dissection with laparoscopic instruments assisted by means of endoscopy. The surgery went smoothly and the patient could be discharged 48 hours after surgery. Final pathological findings reported a well-differentiated tubular adenocarcinoma infiltrating the lamina propria and surgical resection margins free of tumor infiltration (pT1a Nx Mx (TNM 8th Ed. 2017)).