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2005, Number 3

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Cir Gen 2005; 27 (3)

Intragastric laparoscopic surgery (endoluminal), report of two cases

Terrazas EF, Galindo NA, Orduña D, Sanjurjo GJL, Solana LJ, Suárez ME

Language: Spanish
References: 55
Page: 222-228
PDF size: 158.91 Kb.


ABSTRACT

Objective:To describe the experience with two clinical cases in which intragastric laparoscopic surgery was used.
Setting:Third level health care hospital.
Description of cases: Case 1. Woman of 76 years of age with a digestive hemorrhage secondary to a hemorrhagic gastric ulcer at the junction of the body and the antrum, in the posterior face, not excavated; treated with sclerotherapy using epinephrine and polydocanol, which stopped the hemorrhage. Seven days later, a new, same cause, hemorrhagic episode occurred. The gastric cavity was anteriorly approached, an 11-mm blunt-tip trocar was introduced into the stomach followed by a 30° laparoscope and then two, 5- and 10-mm, trocars, the stomach was examined, the ulcer was visualized, four hemostatic points were made, 00 caliber with extracorporeal knots. After a year and a half, she is still asymptomatic. Case 2: Man of 47 years, with a history of chronic alcoholism, two previous pancreatitis events, 7 and 5 years before. He was admitted due to abdominal pain; in the epigastrium, a fixed mass was palpable, at deep planes, renitent and painful. Amylase was of 706 U and lipase of 108 U. Ultrasound and tomography revealed a pseudocyst in the pancreas body with walls of 0.7 cm and 15 cm in diameter. Panendoscopy was performed, confirming the diagnosis. By means of laparoscopy, the pseudocyst was unroofed in a 1.5-cm diameter area, draining the liquid content. The patient was discharged from the hospital on the 3rd day and is asymptomatic after 4 months.
Conclusion:It is technically feasible to use endoluminal, intragastric surgery successfully as a minimally invasive surgery.


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