Gastric Leiomyoma: Intraoperative Ultrasound (IOUS)-Guided Mini-invasive Laparoscopic Enucleation

Leiomyomas are rare benign mesenchymal tumors that can arise at any age and location in the gastrointestinal tract. Gastric leiomyomas are often detected incidentally, and they account for 14 to 30% of all gastrointestinal leiomyomas. Open surgical resection is considered the standard of care for gastric leiomyomas. However, in selected cases, minimally invasive resection is both feasible and safe. We present the case of a 52-year-old previously healthy man with a gastric leiomyoma. Echoendoscopy revealed a subepithelial neoformation in the subcardial region. Histological examination of the biopsy was consistent with a leiomyoma. The video shows the laparoscopic resection of the tumor with the aid of laparoscopic ultrasound to localize the lesion. The postoperative course was regular and free from complications. The histological examination of the excised lesion confirmed the diagnosis of leiomyoma. Intraoperatieve ultrasound-guided laparoscopic resection was performed with a reasonable operation time, low blood loss, and no adverse events. Therefore, this approach can be considered safe and feasible for resecting gastric leiomyoma.