Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis

Jan Dostalik; Petra Gunkova; Igor Gunka; Miloslav Mazur; Tomas Mrazek

doi:10.5114/wiitm.2014.41622

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abstract:

Case report

Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis

Jan Dostalik

,

Petra Gunkova

,

Igor Gunka

,

Miloslav Mazur

,

Tomas Mrazek

Videosurgery Miniinv 2014; 9 (2): 282–285

DOI: https://doi.org/10.5114/wiitm.2014.41622

Online publish date: 2014/03/31

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Although natural orifice specimen extraction is now relatively widely performed, there have been no reports on gastric resection with specimen extraction through the transgastric route for peptic ulcer disease. A hybrid technique of the laparoscopic and endoscopic approach is presented in the case of a 58-year old male patient. Preoperative gastric fibroscopy showed postulcer pyloric and antral stenosis. Laparoscopic exploration confirmed gastric enlargement. Laparoscopic two-thirds gastrectomy was performed. The staple line suture of the residual stomach was excised and the specimen was extracted through the esophagus and mouth with a gastroscope. Finally, the residual stomach was closed again using linear endostaplers. Reconstruction was performed according to the Roux-en-Y method. Gastric resection using natural orifice specimen extraction (NOSE) may be a feasible operative procedure. The NOSE with the combination of standard laparoscopy and specimen extraction through a natural orifice can be considered as a bridge to natural orifice translumenal endoscopic surgery.

keywords:

Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis

Jan Dostalik , Petra Gunkova , Igor Gunka , Miloslav Mazur , Tomas Mrazek

laparoscopy, gastric resection, natural orifice specimen extraction

Jan Dostalik

,

Petra Gunkova

,

Igor Gunka

,

Miloslav Mazur

,

Tomas Mrazek