Page 5 - WJOLS - World Journal of Laparoscopic Surgery

Laparoscopic Management of Polypoidal Lesions of the Stomach

Figs 2A to G: Computed tomography (CT) images

identified on posterior wall along the greater curvature.
Intraoperatively, upper GI endoscopy was done to ensure
adequate margins all around the tumor.
• Wedge resection done using three staplers (2 purple 60, 1 blue
45) and suture line further reinforced with mersilk 3-0. Specimen
was delivered under direct vision via minilaparotomy incision.
Laparoscopic anterior wall gastrotomy with polypectomy
(one patient):
• Ports: 10 mm umbilicus (camera), 12 mm (working) left mid-
clavicular in line with umbilicus, two 10 mm in both subcostal
regions (working and for traction). Pneumoperitoneum created
using open insertion technique and pressure maintained at
12 mm Hg.
• Fundus and greater curvature freed by dividing short gastric
vessels with thunder beat. Anterior wall of the stomach opened
in mid-body close to the attachment of tumor between two
Fig. 3: Adenomatous polyp (operative specimen) silk stay sutures. 7 × 4 cm pedunculated polyp everted out

World Journal of Laparoscopic Surgery, Volume 11 Issue 3 (September–December 2018) 113