1993 Volume 42 Pages 86-90
Out of the total of 373 patients who underwent gastrectomies for mucosal gastric cancers at our department, lymphnode metastases were observed in 10 cases (2.7%) . However, there was no lymphnode metastasis in the cases who had depressed lesions ≤25mm in the major axis or elevated lesions. Therefore, the majority of mucosal gastric cancers were curatively treated by wedge resection of the stomach.
Three patients with mucosal gastric cancer were successfully treated by laparoscopic wedge resection of the stomach. The entire surgical procedure was performed laparoscopically with the assistance of gastroscopy.
The gastric wall in the vicinity of the lesion was pierced with a catheter which had a built-in straight needle. The needle and catheter was laparoscopically pulled out to the outside of the gastric wall. Finally, the lesion was lifted with the support of a small metal rod connected to the end of the catheter (Lesion Lifting Method) . Wedge resection was carried out using an Endo GIA with a sufficient distance from the lesion (more than 6mm) .
The postoperative course was uneventful. The patients could be on a diet on the following day after surgery, and were discharged after 6 days.
If a mucosal gastric cancer was accurately diagnosed preoperatively, laparoscopic wedge resection of the stomach is considered to be a curative and minimally invasive option.
