Resection of Dieulafoy's lesion by a combined endoscopic and laparoscopic approach

Dieulafoy's lesion is a vascular malformation, usually of the stomach but occasionally of the small or large bowel. It is an uncommon but clinically significant source of massive upper gastrointestinal (GI) hemorrhage. The lesion is generally located high on the lesser curvature in the proximal stomach. Although most bleeding can be controlled endoscopically, surgery is occasionally required. The traditional approach was open laparotomy, gastrotomy to localize the lesion, followed by partial gastrectomy or wedge resection. The following case report describes and illustrates a method of intraluminal endoscopic localization of the lesion followed by laparoscopic gastric wedge resection using a 3-port technique.