A new technique for laparoscopic resection of a submucosal tumor on the posterior wall of the gastric fundus

Several reports have been published which describe the technique of using a n Endo GIA to resect submucosal tumors on the anterior wall of the stomach. Lesions on the posterior wall, however, especially near the esophagocardia c junction (ECJ), are difficult to resect using these reported techniques. This is because the surgeon must divide the omentum and enter the omental b ursa in order to use a similar extraluminal technique. Furthermore, special care must be taken to ensure that resections do not involve the ECJ and na rrow the esophagus. In order to overcome these difficulties, we have propos ed a new technique for the laparoscopic excision of a submucosal tumor loca ted on the posterior wall of the gastric fundus. The principle of this proc edure involves the intraluminal resection of the submucosal tumor, includin g the surrounding stomach wall, using the Endo GIA. This technique is safe, simple, and effective. We believe that we are the first to address the exc ision of a submucosal lesion by resecting the full thickness of the posteri or gastric wall lesion intraluminally.