Laparoscopic Resection of Gastric GIST Tumor
Daniel Rice1; David Rattner, MD2
1Lake Erie College of Osteopathic Medicine
2Massachusetts General Hospital
This case illustrates a laparoscopic resection of a gastrointestinal stromal tumor (GIST): the most common mesenchymal tumor found in the gastrointestinal tract. GISTs can be found anywhere along the gastrointestinal tract; however, they are most commonly found in the stomach and small intestine. These tumors are often associated with mutations in the KIT (receptor tyrosine kinase) and PDGFRA (platelet-derived growth factor receptor alpha) genes. Because it is difficult to achieve a permanent cure using protein tyrosine kinase inhibitors, such as imatinib, surgical resection is the recommended therapy in most cases. While the surgical approach may vary on tumor characteristics, the laparoscopic approach is associated with low perioperative morbidity and mortality.
Distal Gastrectomy (Open)
John T. Mullen, MD
Director, General Surgery Resident Program
Massachusetts General Hospital
An 80-year-old patient with anemia undergoes an upper endoscopy that reveals inflammation in the distal stomach. Biopsies identify it as an early intramucosal adenocarcinoma while an endoscopic ultrasound shows the tumor invading the muscle of the stomach. Given that there are no signs of metastasis, the patient presents for a potentially curative gastrectomy where Dr. John Mullen removes the distal two-thirds of the stomach, performs a D1 lymph node dissection and a partial D2 lymph node dissection, and reconstructs in a Billroth II fashion.
Laparoscopic Sleeve Gastrectomy
Massachusetts General Hospital
Ozanan R Meireles MD
General and Gastrointestinal Surgeon
Dr. Meireles expertly conducts the world’s most commonly performed bariatric surgery for weight loss in this JoMI production on textbook sleeve gastrectomies.
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