c l i n i c a l f o l i o s : n a r r a t i v e





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Transhiatal Laparoscopic Esophageal Leiomyoma Resection: 4

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An esophagogram shows the smooth walled mass impinging on the lower esophagus. On repeat questioning, the patient reported progressive difficulty in swallowing over a several month period. Upper endoscopy showed normal intact esophageal mucosa over the lesion. Endoscopic biopsy came back smooth muscle consistent with leiomyoma.      

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Transhiatal Laparoscopic Esophageal Leiomyoma Resection: 5

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The patient was taken to the operating room for a transhiatal laparoscopic resection of the tumor. A 10-mm camera port was placed at the umbilicus and a second 10-mm port was placed in the left anterior axillary line below the costal margin. Two lateral 5-mm ports were placed at the level of the umbilicus. A conformable liver retractor was placed through the right-sided port to hold the large left lobe up out of the way.      

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Transhiatal Laparoscopic Esophageal Leiomyoma Resection: 6

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The esophagophrenic ligament was opened and the esophagogastric junction was bluntly mobilized anteriorly and laterally.     

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This page was last modified on 9/8/2005.