AIM:Laparoscopic resection of tumors on the posteriorwall of gastric fundus,especially when they are next to theesophagocardiac junction(ECJ),is both difficult and time-consuming.Furthermore,it can lead to inadvertent esophagusstenosis and injury to the spleen.In order to overcomethese difficulties,laparoscopically extraluminal resectionof gastric fundus was designed to manage submucosaltumors located on the posterior wall of gastric fundus andnext to ECJ.METHODS:From January 2001 to September 2003,laparoscopically extraluminal resection of gastric funduswas successfully carried out on 15 patients.There were11 males and 4 females with an average age of 58 years(range,38 to 78 years).The mean diameter of the tumorswas 4.8 cm.The distance of the tumor border from ECJwas about 1.5-2.5 cm.The four-portal operation procedureswere as follows:localization of the tumor,dissection ofthe omenturn,mobilization of the gastric fundus and theupper polar of spleen,exposure of ECJ,and resection ofthe gastric fundus with Endo GIA.RESULTS:The laparoscopic operation time averaged(66.2±10.4)min,the average amount of bleeding was(89.4±21.7)mL.The mean post-operative hospital staywas(5.3±1.1)d.Within 36 h post-operation,73.3% of allthe patients recovered their gastrointestinal function andbegan to eat something and to walk.In all the operations,no apparent tumor focus was left and no complication orconversion to open surgery occurred.CONCLUSION:Our newly designed procedure,laparoscopically extraluminal resection of the gastricfundus,can avoid contamination of the abdominal cavity,injury to the spleen and esophageal stenosis.The procedureseems to be both safe and effective. AIM: Laparoscopic resection of tumors on the posterior wall of gastric fundus, especially when they are to the esophagocardiac junction (ECJ), is both difficult and time-consuming. Stillrther, it can lead to in advertent esophagusstenosis and injury to the spleen. In order to overcomethese difficulties, laparoscopically extraluminal resection of gastric fundus was designed to manage submucosal tumors located on the posterior wall of gastric fundus and next to ECJ. METHODS: From January 2001 to September 2003, laparoscopically extraluminal resection of gastric fundus successfully done out on 15 patients. and 4 females with an average age of 58 years (range, 38 to 78 years) .the mean diameter of the tumorswas 4.8 cm.The distance of the tumor border from ECJwas about 1.5-2.5 cm.The four-portal operation procedureswere as follows : localization of the tumor, dissection of the omenturn, mobilization of the gastric fundus and the perper polar of spleen, exposure of ECJ, and resection ofthethe gastric fundus with Endo GIA.RESULTS: The laparoscopic operation time averaged (66.2 ± 10.4) min, the average amount of bleeding was (89.4 ± 21.7) mL.The mean post-operative hospital staywas (5.3 ± 1.1) d.Within 36 h post-operation, 73.3% of all patients recovered their gastrointestinal function and began to eat something and to walk. all of operations, no apparent tumor focus was left and no complication orconversion to open up occurred occurred. CONCLUSION: Our newly designed procedure, laparoscopically extraluminal resection of the gastricfundus, can avoid contamination of the abdominal cavity, injury to the spleen and esophageal stenosis. the procedureseems to be both safe and effective.