Abstract

• Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Although GISTs can occur anywhere along the GI tract, they are most frequently found in the stomach and small intestine. Duodenal GISTs are rare but clinically significant due to their symptomatology and potential for malignant transformation. Surgical resection remains the cornerstone of curative treatment. Laparoscopic surgery is now the main method for duodenal GIST due to its advantages, including a faster recovery, less pain, and shorter hospital stay. In this video, we demonstrate how we make different choices regarding the surgical methods for duodenal GIST during operation. The technical points are as follows: (1) preliminary judgment of the tumor location according to the preoperative computed tomography scan and gastroscopy findings, (2) fine dissection of the soft tissue and vessels around the duodenum, (3) intraoperative gastroscopy to confirm the tumor location, (4) the final decision regarding the surgical method according to the tumor location and size, (5) confirmation of luminal patency and hemostasis by intraoperative endoscopy.