As the incidence of early gastric cancer rises, the need for gastric tumor localization further increases. Furthermore, in the era of minimally invasive surgery, the development of preoperative or intraoperative tumor localization techniques for small-sized tumors has become more important. Under laparoscopic gastric surgery, it is difficult to determine the actual location and safe resection margins of the tumor. Thus, tumor localization is important because laparoscopic surgery has less tactile sensation than open surgery, and with the increase in the early diagnosis of gastric cancer, tumors are smaller.
There are several types of tumor localization methods in gastric cancer surgery. The first is to perform an endoscopy during surgery. However, this increases the operation time, and the air inflation of the intestines makes the operation difficult. The second method is to use a metal clip during the endoscopy and prior to the surgery. With this technique, the patient may be exposed to radiation as an X-ray may be taken to confirm the position of the metal clip during surgery . The third method is endoscopic tattooing which uses tattooing agents such as methylene blue, India ink, and indocyanine green. This could lead to a technical failure due to ineffective tattooing or result in intraperitoneal complications caused by tattoo chemical spillage . All of these techniques require additional endoscopic examination or a portable X-ray or ultrasound.
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The author has no conflicts of interest to declare.