Balloon-tipped cannulas for use in laparoscopic diagnosis and treatment ofacute upper GI bleeding

Background: Percutaneous balloon-tipped laparoscopic cannulas designed for preperitoneal hernia repair can be readily used to treat gastric bleeding l aparoscopically. Methods: Between 1995 and 1997, we successfully used balloon-tipped cannula s to visualize, biopsy, and suture acutely bleeding gastric lesions in five patients. These case histories are reviewed for this study. Results: Patients received an average of six units of blood preoperatively (range, 0-15). Operative time averaged 207 min (range, 149-270), At surgery gastrotomies were made for cannula placement under laparoscopic visualizat ion. Operative findings included: lesser curve gastric ulcer, Mallory-Weiss tear, prepyloric ulcer, duodenal ulcer, and angiosarcoma, Three patients h ad successful percutaneous suture of bleeding gastric lesions. One patient was converted to open surgery. One patient had local resection of an angios arcoma. Conclusion: The laparoscopic use of balloon-tipped cannulas allows the expe ditious diagnosis and treatment of acute gastric hemorrhage.