ABSTRACT
Brunner's gland hamartoma (adenoma) was first described in 1876. It is a rare hamartomatous lesion, with only 100 cases reported in the world literature. Treatment has been by endoscopic snaring. Open surgical excision was reserved for cases where snaring had failed. We report a case of a Brunner's gland hamartoma (2.4 cm) that was successfully resected by laparoscopic techniques. Postoperative hospital stay was brief (2 days), and there were no complications. This is the second reported case to be resected laparoscopically.
Subject(s)
Brunner Glands/pathology , Brunner Glands/surgery , Duodenal Diseases/surgery , Duodenum/surgery , Hamartoma/surgery , Laparoscopy/methods , Duodenal Diseases/pathology , Duodenum/pathology , Hamartoma/pathology , Humans , Male , Middle Aged , Postoperative Care/methodsABSTRACT
Esophageal leiomyoma are usually intramural and the most common minimally invasive approach is thoracoscopic excision leaving the mucosa intact. We report the case of a 58-year-old woman who underwent laparoscopic excision of a pedunculated esophageal leiomyoma.
Subject(s)
Esophageal Neoplasms/surgery , Esophagoscopy/methods , Laparoscopy/methods , Leiomyoma/surgery , Biopsy, Needle , Esophageal Neoplasms/diagnosis , Female , Follow-Up Studies , Humans , Leiomyoma/diagnosis , Middle Aged , Minimally Invasive Surgical Procedures/methods , Treatment OutcomeABSTRACT
Laparoscopic fundoplication has become the standard operation for gastroesophageal reflux disease. In our service, a laparoscopic fundoplication is performed as a 2-cm floppy 360 degrees wrap with division of the short gastric vessels and the fundoplication is sutured using a prolene 2/0 mattress suture (Ethicon, USA) and buttressed laterally with two teflon pledgets (PTFE 1.85 mm; low porosity, Bard, USA). We report a patient with post-operative dysphagia due to an esophagogastric fistula caused by erosion of a teflon pledget. This is the first such case in 734 laparoscopic fundoplications performed between January 1991 and December 1998. Reoperation was required, resulting in a prolonged convalescence. A review of current literature has not revealed any similar cases. Causes for this rare complication are postulated.
