Abstract
We report a case of hand assisted laparoscopic surgery (HLS) for gastric schwannoma. The patient was a 65-year-old woman, who had been asymptomatically diagnosed to have gastric extramural tumor, and gallbladder polyp. Because of its growing in 8 months, she was hospitalized for surgical treatment. We started the operation under the open method of laparoscopic surgery using the intraabdominal pressure of 8 mmHg. Three ports were inserted into the abdomen as follows ; upper umblication (15mm) , below the xiphoid process on the median line (5mm) , and the right abdomen (11.5mm) . The tumor of the maximum diameter of 7 cm was observed on the greater curvature without any adhesion to other organs. After I enlarged the wound of the port below the xiphoid process on the median line to 5cm, I put my right hand into the abdomen using LAP-DISK and performed the partial resection of the stomach by Endo-GIA. The cholecystectomy underwent simultaneously performed for the gallbladder polyp. The size of the gastric tumor was 6.5cm×4.3cm×4.0cm. The tumor was diagnosed as gastrointestinal stromal tumor by frozen sections, but the added immunohistochemical staining of the tumor was positive only for S-100 protein. It was eventually diagnosed as gastric schwannoma.
