Endoscopy 1999; 31(5): 398-400
DOI: 10.1055/s-1999-25
Case Report
Georg Thieme Verlag Stuttgart ·New York

Laparoendoscopic Excision of a Duodenal Mass

K. S. Gersin, B. T. Heniford, H. Baradi, J. L. Ponsky
  • Minimally Invasive Surgery Center, Dept. of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Further Information

Publication History

Publication Date:
31 December 1999 (online)

Introduction

Lipomas of the small intestine occur predominantly in men, and are located in the ileum or duodenum [[1]]. Asymptomatic lipomas found incidentally can be left untreated, as they have no malignant potential [[1] [2]]. Excision is typically required only if the lesion is symptomatic, manifested by bleeding, obstruction, or intussusception [[3] [4] [5] [6]].

Excision of small lipomas can be accomplished endoscopically using standard polypectomy techniques. Large lipomas are often not amenable to endoscopic resection, due to concerns about bleeding and bowel perforation associated with their removal. In these instances, complete excision has traditionally required laparotomy with enterotomy, or segmental intestinal resection [[5]].

Recently, flexible endoscopy has been used as an adjunct to increasingly complex laparoscopic procedures. This „marriage” of current technologies is allowing the successful performance of these technically demanding procedures. Using these two technologies, intraluminal bowel lesions can be removed laparoscopically, avoiding the need for laparotomy and preserving the benefits of minimally invasive procedures. Our group reports here on the excision of a large, sessile duodenal mass using these laparoendoscopic techniques.

References

  • 1 Greenfield L J, Mulholland M W, Oldham K T, Zelenock G B. Surgery: scientific principles and practice.  Philadelphia,; Lippincott 1993
  • 2 Cameron L J. Current surgical therapy. 5th edition.  Missouri,; Mosby 1995
  • 3 Imamura K, Fuchigami T, Iida M, et al. Duodenal lipoma: a report of three cases.  Gastrointest Endosc. 1983;  29 223-4
  • 4 Michel L A, Ballett T, Collard J M, et al. Severe bleeding from submucosal lipoma of the duodenum.  J Clin Gastroenterol. 1988;  10 541-5
  • 5 Sarma D P, Weilbaecher T G, Basavaraj A, Reina R R. Symptomatic lipoma of the duodenum.  J Surg Oncol. 1984;  25 133-5
  • 6 Stayman J W, Heath A O. Intussusception from duodenal lipoma.  Pa Med. 1966;  69 43-5
  • 7 Ponsky J L, King J F. Endoscopic marking of colonic lesions.  Gastrointest Endosc. 1975;  22 42-3

K. S. GersinM.D. 

Dept. of General Surgery

Berkshire Medical Center

Surgical Specialists of Western New England

510 North Street

Pittsfield, MA 01201

USA

Phone: + 1-413-442-3101