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A Simple Method to Aid Safe Resection Margin During Sleeve Gastrectomy in Patients With Incidental Gastric Lesions

Yerdel, Mehmet Ali, MD; Özgen, Görkem, MD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: December 2018 - Volume 28 - Issue 6 - p e106–e108
doi: 10.1097/SLE.0000000000000553
Online Articles: Technical Reports

In contrast to colonic tattooing, data on dye-marking before gastric operations are scarce. A simple method of gastric tattooing before sleeve gastrectomy (SG) is presented. SG, under tattoo guidance has never been reported. Submucosa of the lesion is injected with 1 to 2 mL of carbon particles (Spot, PA) 24 hours before SG. At surgery, serosal dye stain is identified and stapling achieved with care to remove all dye-stained segment. Dye spread on the serosal surface differed significantly. However, as all the dye-stained segments were avoidable during stapling, 2 neuroendocrine tumors, 2 leiomyomas, and 1 benign ulcer were resected with clear histologic margins. The method presented herein may decrease the need for operative gastroscopy, mucosal resection, or laparoscopic gastrotomy in a number of patients. Because of the problem of the dye spreading, its utilization may be inappropriate in lesions that are closer to the minor curvature and incisura angularis in particular.

İstanbul Bariatrics, Obesity Center, İstanbul, Turkey

The authors declares no conflicts of interest.

Reprints: Mehmet Ali Yerdel, MD, İstanbul Bariatrics, Polat Tower, Fulya Mahallesi, Yeşil Çimen Sok., No:12, Şişli, İstanbul 34394, Turkey (e-mail:

Received April 16, 2018

Accepted May 29, 2018

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