부산대학교 도서관

A 66-year-old woman visited our hospital because of melena. Despite gastrofiberscopic and colonoscopic exams, the bleeding source was unclear. We suspected a small intestinal lesion, and performed double-balloon enteroscopy. A submucosal tumor in the small intestine was found and this tumor was considered to be the bleeding source. An abdominal computed tomography scan showed an enhanced diffuse thickening of the small intestinal wall and lymph node metastasis. However, it was difficult of make a preoperative diagnosis, because endoscopic biopsy was impossible. Therefore, single incision laparoscopic surgery (TANKO) was performed in order to make the diagnosis and for treatment of the small intestinal tumor. Ileocecal resection and anastomosis were performed under umbilical minimal incision with TANKO. We were able to perform a less invasive surgery and effective diagnosis and resection with TANKO. For this case of small intestinal malignant lymphoma, TANKO was very useful.