Balloon-tipped cannulas for use in laparoscopic diagnosis and treatment of acute upper GI bleeding

Background: Percutaneous balloon-tipped laparoscopic cannulas designed for preperitoneal hernia repair can be readily used to treat gastric bleeding laparoscopically. Methods: Between 1995 and 1997, we successfully used balloon-tipped cannulas to visualize, biopsy, and suture acutely bleeding gastric lesions in five patients. These case histories are reviewed for this study. Results: Patients received an average of six units of blood preoperatively (range, 0–15). Operative time averaged 207 min (range, 149–270). At surgery, gastrotomies were made for cannula placement under laparoscopic visualization. Operative findings included: lesser curve gastric ulcer, Mallory-Weiss tear, prepyloric ulcer, duodenal ulcer, and angiosarcoma. Three patients had successful percutaneous suture of bleeding gastric lesions. One patient was converted to open surgery. One patient had local resection of an angiosarcoma. Conclusion: The laparoscopic use of balloon-tipped cannulas allows the expeditious diagnosis and treatment of acute gastric hemorrhage. Received: 31 March 1998/Accepted: 26 February 1999