Laparoendoscopic Excision of a Duodenal Mass

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

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