Laparoscopic resection of submucosal tumor on posterior wall of gastric fundus

Figure 1 Submucosal tumors on gastric fundus diagnosed in preoperative examinations. A: A lesion near to ECJ with a clear-cut margin shown in barium swallow examination of upper gastrointestine; B: A lesion with a clear-cut margin protruded into gastric lumen shown in ultrasonic gastroscopy; C: A hemisphere-like projection in the posterior wall of gastric fundus and an ulcer in its center shown in gastroscopy.

Figure 2 Trocar positions for laparoscopically extraluminal resection of gastric fundus. A: Endoscope portal (10 mm); B, C: Main working portals (10-12 mm); D: Assisting working por-tal (5 mm).

Figure 3 Resection of gastric fundus with Endo GIA. A: The blue line represents the Endo GIA resection line; B: When Endo GIA was placed near the cardia, special care was taken to ensure that ECJ was not involved.

Figure 4 Resected specimens. Line a: the distance of the tumor to ECJ.