Laparoscopic partial resection for hemangioma in the third portion of the duodenum

Figure 3 Laparoscopic resection of the duodenal hemangioma. A: Intraoperative gastroduodenal endoscopy shows the intraluminal location of the hemangioma (white arrowheads), corresponding with the location identified by laparoscopy with the serosal color change of the duodenum (black arrowheads); B: Resection of the lesion was performed using ultrasonic coagulating shears with a laparo-endoscopic view; C: The defect of the duodenal wall was closed manually using an intracorporeal running suture in the whole layer. The suture line (black arrowheads) was extremely close to the pancreas (white arrowheads); D: After the intracorporeal running suture was placed in the seromusclar layer, the duodenum was reinflated during the laparoscopy to detect any bleeding or leakage from the suturing line (black arrowheads) and to confirm a patent lumen by intraluminal endoscopy.