Laparoscopic transgastric resection for intraluminal gastric gastrointestinal stromal tumors located at the posterior wall and near the gastroesophageal junction

摘要

We read the article entitled “Laparoscopic transgastric resection for intraluminal gastric gastrointestinal stromal tumors located at the posterior wall and near the gastro- esophageal junction” discussing a minimally invasive treatment for intraluminal gastric gastrointestinal stromal tumors at a specific location by Siow SL et al' in this journal with great interest. They reported that Nathason liver retractor had been used in selected cases when the upper part of the stomach was overlapped by bulky liver. During laparoscopic upper gastrointestinal procedures, the field of vision is often obscured by the left lobe of the liver and the bulky round ligament.” An adequate workspace and a clear view are crucial in any minimally invasive surgery, espe- cially in single-port laparoscopic upper abdominal surgery.° Several techniques*”’ including Nathason liver retractor have been reported to optimize the operative view and the working space, but they require another trocar for insertion and may cause iatrogenic liver injury. So a safe and stable liver retraction is of particular interest. A new idea described below was utilized to aid in improving the field of view during surgery without inducing liver dysfunction in using the technique.