Novel surgical approach for gastric gastrointestinal stromal tumor (GIST): Robotic single port partial gastrectomy

Abstract

BackgroundMinimally invasive resection of gastrointestinal stromal tumors (GIST) results in faster recovery and similar oncological safety when compared to conventional approach [1–3]. The new robotic Single Port platform (Da Vinci SP) could help decreasing invasiveness while overcoming technical limitations of previous single incision surgical approaches [4]. MethodsA 69-year-old male was treated for a 3 cm non-ulcerated GIST in the anterior wall of the proximal gastric body. ResultsA robotic partial gastric resection was performed. The Da Vinci SP platform, which hosts three multi jointed, wristed instruments and a 3D HD articulating scope was used. The camera and instruments were introduced in the abdominal cavity through a 25 mm multichannel port. The lesion was identified in the lesser curvature at the level of the body, approximately 3 cm above the incisura. The gastric wall was resected en-bloc with the tumor using a combination of monopolar hook and bipolar forceps. The lesion was lifted using the third robotic arm and was not manipulated during the dissection. The gastric defect was closed with two running sutures of polydioxanone 3/0. Operative time was 82 minutes. Postoperative course was uneventful, and the patient was discharged home on postoperative day 2 with adequate pain control. Histopathology analysis found a 2.3 × 2 cm low grade GIST. ConclusionsRobotic SP partial gastrectomy is safe and feasible in patients with gastric GIST. The robotic SP approach might help expanding the indications of previous single incision techniques.