Laparoscopic Gastric Wedge Resection

Port placement (Umbilical port)

1. Incise skin and dissect down to fascia.
2. Place fascial stay sutures and open fascia and peritoneum.
3. Sweep any abdominal structures away from port site with finger sweep.
4. Place umbilical port.
5. Other two ports placed under direct vision of camera passed through abdominal port.

Inspection of abdominal contents

6. Identify any peritoneal adhesions.

Placement of lateral ports

7. Under direct vision via umbilical port

Identification of stomach and greater omentum

Mobilization of greater omentum and entry into lesser sac

8. Ligasure used to divide short gastric vessels close to edge of greater curvature of the stomach.

Identification of mass

9. Mass tattooed preoperatively by gastroenterology service.

Excision of mass

10. Endo-GIA stapler with 45mm load used to staple across base of mass.

Lysis of adhesions

Closure

11. Removal of specimen via endo-catch bag
12. Inspection of abdominal contents and gastric staple line
13. Fascial closure
14. Infiltration of local anesthetic