Robotic Partial Gastrectomy for Gastric Gastrointestinal Stromal Tumor (GIST)
This operative video demonstrates a robotic partial gastrectomy performed for a gastrointestinal stromal tumor (GIST) of the gastric fundus.
The patient is a 59-year-old woman who presented with an enlarging gastric mass consistent with a gastrointestinal stromal tumor on prior biopsy.
The patient underwent robotic staging laparoscopy followed by robotic partial gastrectomy.
Intraoperative evaluation demonstrated a 2.5 cm exophytic lesion arising from the anterior aspect of the gastric fundus. The tumor was elevated and resected using a robotic stapled wedge resection.
Frozen section analysis demonstrated a close margin at the staple line, and therefore the staple line was re-excised to obtain an additional margin. The gastrotomy was then closed transversely with a running hand-sewn suture.
An intraoperative upper endoscopy was performed to evaluate the gastric lumen and the repair. The stomach was insufflated while the repair site was submerged intra-abdominally, and a hydropneumatic leak test confirmed the integrity of the closure.
The patient tolerated the procedure well and was discharged home on postoperative day two.
Final pathology demonstrated:
Gastrointestinal stromal tumor, spindle cell type
Tumor size 4.5 cm
Mitotic rate <5 per 5 mm²
Very low risk category
All margins negative for tumor
This case demonstrates the application of robotic minimally invasive techniques for gastric GIST resection, including precise tumor localization, margin assessment, and intraoperative endoscopic evaluation.