Single-incision Laparoscopic and Endoscopic Cooperative Intragastric Surgery for a Submucosal Tumor of the Gastric Cardia

Abstract

The patient was a woman in her 40s who had previously been detected as having a submucosal tumor of the cardia, and surgical resection was deemed necessary, because the tumor had increased to 30 mm in diameter. The tumor was of the intraluminal type, and was located from the cardia to the esophageal mucosa. A 3-cm median incision was made along the upper abdominal midline. The stomach was elevated outside the peritoneal cavity; an approximately 3-cm incision was made at the gastric angle, and a pneumostomach was established. After the mucosa at the tumor margin was completely incised under endoscopic guidance, the muscle layer was dissected under laparoscopic guidance, and the tumor was removed. The tumor was diagnosed as a leiomyoma by histopathological examination. The postoperative course was favorable, and the patient was discharged on day 8. Laparoscopic and Endoscopic Cooperative Intragastric Surgery allowed us to successfully remove a submucosal tumor with minimal invasion. In regard to the adaptation and the procedure, we propose to report it with a consideration of the relevant literature.