Cooperative laparoscopic endoscopic and hybrid laparoscopic surgery for upper gastrointestinal tumors: Current status

Figure 3 Endoscope-assisted laparoscopic intragastric and transgastric resection technique. A: Localization of the tumor at the posterior gastric wall by endoscopy and the position of the anterior gastric wall overlying the tumor is shown to the laparoscopic team by transillumination; B: Transgastric resection: the anterior gastric wall is sectioned (gastrotomy) to give laparoscopic access to the gastric lumen and the tumor; C: Intragastric resection: the laparoscopic ports are inserted through the abdominal wall and through the gastric wall inside the gastric lumen; the gastric wall is held in contact with the abdominal wall by means of the balloon tipped laparoscopic ports.