Robotic-assisted free-handed, full-thickness gastric GIST resection with primary repair in unfavorable locations

Complete R0 resection of gastrointestinal stromal tumors (GIST) of the stomach without signs of metastasis is highly reported, and the techniques for tumor resection have been evolving. Previously, laparoscopy was suggested to be safe only for GIST tumors < 2 cm. More recent reports demonstrate safety of resecting gastric GIST tumors laparoscopically > 5 cm even in unfavorable locations defined as GE junction, lesser curvature of gastric body, posterior wall of gastric body, and antrum. The most common resection method for gastric GIST resection is wedge resection, regardless if the surgery is completed open, laparoscopic, or robotically. Free-handed, full-thickness resection with primary repair is not commonly reported. This paper includes three cases of gastric GIST tumors in unfavorable locations resected robotically, free-handed, full-thickness resection with primary repair.