E. Kanehira et al., A TECHNIQUE OF PERCUTANEOUS ENDOSCOPIC INTRAGASTRIC SURGERY, MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES, 7(1), 1998, pp. 15-20
A technique of percutaneous endoscopic intragastric surgery (PEIGS) is
described. In PEIGS, three cannulae are inserted percutaneously into
the gastric cavity, using a technique similar to that used in percutan
eous endoscopic gastrostomy. Through these intragastric cannulae a rig
id endoscope and two surgical instruments are brought into the gastric
cavity. The gastric cavity is dilated by CO, insufflation and large e
n bloc mucosectomy is carried out using a grasper and a high-frequency
hook under percutaneous gastroscopic view. The mucosal defect is clos
ed by suturing. After removal of the intragastric cannulae, the wounds
in the stomach are closed by suturing. We also report a case with a l
arge sessile adenoma in the gastric antrum containing a cancer focus.
In this case we were able to remove the lesion (measuring 80 mm at its
greatest diameter) in en bloc fashion by the PEIGS technique. During
the follow-up period of 3 years the patient has had no tumour recurren
ce and enjoys an excellent quality of life. PEIGS can be a preferred c
hoice of therapy in selected patients with sessile adenomas and carcin
oma in situ of the stomach, and may also be used for other pathologies
, such as pancreatic pseudocyst or intractable gastric haemorrhage.