Gastric lipoma excision during a laproscopic sleeve gastrecomy: A case report

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A new management option for patients with submucosal gastric tumors.

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Combing two procedures in one surgery, maybe beneficial for some submucsal gastric tumors removals.

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The importance of through preoperative and intraoperative assessment for all bariatric procedures.

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Surgeon opinion along with patient preference are key factors in any elective operation.

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This is the second case report in the medical English literature to remove this rare gastric tumor during an elective bariatric surgery.

Introduction

Gastric lipomas are rare benign mesenchymal tumors of the stomach.

Case report

We report a 41 year old, morbid obese male, admitted for elective laparoscopic sleeve gastrectomy. Thorough preoperative assessment revealed a gastric lipoma in the antrum of the stomach measuring 3 × 3 cm. Due to the patient’s preference, surgical resection of the lipoma was done along with the laparoscopic sleeve gastrectomy procedure.

Discussion

In our case, we report a rare case of submucosal gastric lipoma successfully removed during a laparoscopic sleeve gastrectomy. To our knowledge, this is the second case report in the medical English literature that reports removing this rare gastric tumor during an elective bariatric procedure.

Conclusion

This case report presents an effective treatment option for patients in need of bariatric procedure and gastric lipoma resection. This case also highlights the importance of through preoperative and intraoperative assessment for all bariatric patients.

Minimally invasive surgeries for submucosal tumors of the stomach

Submucosal tumors (SMTs) of the gastrointestinal tract, which may be an occasional finding on routine upper gastrointestinal (GI) endoscopy, represent a diagnostic and therapeutic challenge. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract and have the potential to progress to malignancy. The primary treatment goal for localized GISTs is surgical resection with achievement of a negative margin (R0 resection). This is the effective way to achieve complete treatment. Minimally invasive surgery has become common in the surgical resection of gastrointestinal SMTs. Recent advances in endoscopic technology provide various treatment modalities for gastric SMTs. Moreover, investigators have developed laparoscopic and endoscopic cooperative procedures. In addition, robotic surgery for SMTs is another choice. The purpose of this article is to review recent trends in minimally invasive surgery for gastric SMTs.

Symptomatic subserosal gastric lipoma successfully treated with enucleation

Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptomatic subserosal gastric lipoma which was successfully managed with removal, enucleation of lipoma, explorative gastrotomy and edge resection for histology check of gastric wall. The incidence of gastric lipoma, advanced diagnostic possibilities and their role in treatment modalities are discussed.