Abstract
A 64-year-old man who underwent distal gastrectomy with Billroth-II reconstruction for gastric ulcer 15 years earlier was pointed out having a submucosal tumor of the stomach growing within the lumen at the lesser curvature of the cardiac part of the remnant stomach. Cytodiagnosis under endoscopic ultrasonography was gastrointestinal stromal tumor (GIST), and we planned surgery for the patient. Taking the minimal invasiveness and preservation of function into consideration, we performed local resection of the stomach using laparoscopic endoscopic cooperative surgery (LECS). We put a holding thread around the surgical defect under laparoscopy and closed it by using a stapling device. The operating time was 288 min and the blood loss amounted to 153 ml. The postoperative course was uneventful and the patient was discharged from the hospital on the 11th postoperative day.
The use of LECS enabled us to maintain the minimal invasiveness, preservation of function, and radicalness of surgery at the same time even for such a patient as should be performed total gastrectomy of the remnant stomach by laparotomy in accordance with the conventional surgical standards.
