New method for jejunal pouch interposition reconstruction after distal gastrectomy.

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Medical Devices

Background:

• Pouch reconstruction enhances quality of life after gastric cancer surgery.
• Jejunal pouch reconstruction, while beneficial, is complex and time-consuming.
• A novel technique using a linear stapling device was developed to address these challenges.

Purpose of the Study:

• To introduce and evaluate a simplified technique for jejunal pouch reconstruction.
• To reduce operative time and complexity in distal gastrectomy for gastric cancer.
• To maintain or improve functional outcomes and quality of life for patients.

Main Methods:

• Simultaneous division of duodenum and jejunum using a 100-mm linear stapler.
• Side-to-side jejunojejunostomy performed with a linear stapler.
• Simultaneous end-to-end posterior gastrojejunal anastomosis using a linear stapler during gastrectomy, followed by hand-sewn anterior anastomosis.

Main Results:

• The technique was successfully applied in 4 patients.
• No complications related to the pouch or anastomoses were observed.
• Mean operative time was 255 ± 37 minutes, with a range of 205-290 minutes.

Conclusions:

• The new linear stapling technique significantly shortens operative time.
• Simultaneous posterior gastrojejunal anastomosis using the stapler during gastrectomy is key to time reduction.
• This simplified approach offers a promising alternative for jejunal pouch reconstruction in gastric cancer surgery.