2018 Volume 67 Issue 1 Pages 27-32
We report a case of 70-year-old female with a solitary fundus gastrointestinal stromal tumor（GIST），which was resected and reconstructed with a double-flap technique using laparoscopic sutures. We discuss the surgical technique and its advantage of a double-flap reconstruction. CT showed a 50 mm × 50 mm tumor in the gastric fundus and PET-CT depiced a high accumulation of FDG（SUVmax：13.7）in stomach only. The patient was diagnosed to have a solitary gastric fundus GIST, and we performed laparoscopic proximal gastrectomy and reconstructed with a double-flap technique under laparoscopic sutures. There was no postoperative reflux esophagitis or stagnation symptoms, and meal intake is optimal. Because anastomosis is sewn by hand, flexibility of the anastomotic site is maintained and it has an effect on preventing reflux esophagitis. While the techniques are complicated, it is needed to become familiar with the suture/ligation techniques within the abdominal cavity and use of the appropriate devices.
