Is combined bimicroscopic resection of gastric tumors effective?

  At the beginning of the New Year, Professor Zhu Xiaocheng’s team, director of the Gastroenterology Treatment Center, with the active cooperation of the Department of Gastroenterology, successfully performed an intraoperative bimicroscopic combined laparoscopic gastric wedge resection for a patient with fundic tumor using the newly equipped imported high-definition gastroscope in the Gastroenterology Center. The patient is now being successfully discharged from the hospital.  The patient, a 67-year-old male, was admitted to our gastroenterology center for fundic tumor found by gastroscopy. The pathology of gastroscopic biopsy suggested benign gastric lesion, which was difficult to be resected under conventional gastroscopy due to the large size of the lesion and its location at the bottom of the stomach. After thorough preoperative preparations and detailed treatment plan, Professor Zhu Xiaocheng’s team performed intraoperative double-scope combined exploration on the patient. Intraoperative gastroscopy confirmed that the tumor was located in the fundus of the stomach, only 2.5×1.0×0.5 cm in size, and the lesion could not be found under conventional laparoscopy. The tumor was localized by gastroscopy and confirmed outside the gastric cavity by lumpectomy, and a wedge resection of the stomach was performed. The patient was out of bed on the second day after surgery.  Prof. Zhu Xiaocheng introduced that the combined laparoscopic and endoscopic technique is an emerging technique in recent years, which gives full play to the respective advantages of soft and hard mirrors, complementing each other’s strengths and creating favorable conditions for each other, making up for the shortcomings of a single endoscope or laparoscope, and making certain difficult problems easy to solve. For laparoscopic surgery of early benign gastric tumors, it is difficult to locate such lesions due to the lack of hand touching sensation of simple laparoscopy because the appearance of gastrointestinal wall is mostly unchanged. In order to avoid unnecessary laparotomy and ensure precise positioning during surgery, the combined laparoscopic gastroscopy technique was developed, which not only ensures the accuracy and integrity of lesion removal, but also reduces the chance of miscutting and abdominal cavity contamination without the need to open the gastric wall for investigation, and shortens the operation time, reduces bleeding, reduces trauma, and fastens postoperative recovery. With the backing of laparoscopy, more patients can have the opportunity to try gastroscopic electrocautery to remove tumors without worrying about complications such as perforation and bleeding, and at the same time, gas injection through the gastroscope can check for stenosis and air leakage to ensure the quality of surgery.