[Transgastric laparo-endoscopic approach for difficult access lesions. Experimental mode]

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastroenterology

Context:

• Laparoscopic surgery is effective for gastric neoplasms, but some locations are inaccessible.
• A transgastric approach offers an alternative for difficult-to-reach lesions.
• Posterior gastric neoplasms near the cardia and pylorus pose a surgical challenge.

Purpose:

• To evaluate the feasibility and safety of a laparoscopic transgastric approach for resecting posterior gastric neoplasms in an animal model.
• To assess the efficacy of this technique for tumors located near the esophagogastric junction and pre-pyloric region.

Summary:

• A laparo-endoscopic technique was developed and tested in twelve pigs.
• The procedure involved endoscopic visualization, intragastric trocar insertion, CO2 insufflation, and resection with a 20 mm margin.
• All resections were successful within an average of 102.33 minutes, with two complications and no mortality.

Impact:

• The laparoscopic transgastric approach provides excellent exposure for posterior gastric neoplasms.
• This technique is feasible and safe for resecting lesions near the esophagogastric junction and pre-pyloric region.
• This minimally invasive method expands treatment options for challenging gastric tumor locations.