Laparoscopic Wedge Resection of a 6 cm Gastrointestinal Stromal Tumor (GIST) Arising From the Lesser Curvature: A...

Laparoscopic wedge resection of gastrointestinal stromal tumors (GISTs) is the preferred approach for small-sized tumors. Our case study aims to clarify the feasibility of laparoscopic resection of a 6 cm GIST from the lesser curvature in elderly patients, thereby avoiding major gastrectomy. We present a 75-year-old female patient, diabetic and hypertensive, from Amman, Jordan, who had been suffering from epigastric pain and vomiting for a duration of three months. The computed tomography (CT) scan and endoscopy revealed a 6 cm gastric mass arising from the lesser curvature, 4 cm away from the gastroesophageal junction (GEJ), confirmed by endoscopic ultrasound-guided biopsy as a GIST. The patient was referred to a hematologist for possible mass regression with neoadjuvant imatinib. She was then returned to the surgical team after developing drug intolerance, which exacerbated vomiting. The decision was made for laparoscopic resection based on her clinical scenario, and after full preoperative preparation, the procedure was performed in June 2025 at King Hussein Medical Center. The patient underwent full laboratory and radiological investigations before surgery. She also underwent an endoscopy for mass localization. The procedure was performed successfully through a laparoscopic approach via wedge resection using an endo gastrointestinal anastomosis (GIA) stapler over a 40 F (French) Bougie, followed by a negative methylene blue test. After surgery, the patient was monitored in the general ward and was found to be well. A Gastrografin study was performed to assess the gastric anatomy after resection and to rule out leakage. The patient was discharged on the first postoperative day after tolerating oral intake and was followed up as an outpatient for three months without significant complaints.