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Related Experiment Videos

A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis.

Shuji Takiguchi1, Mitsugu Sekimoto, Yoshiyuki Fujiwara

  • 1Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0876, Japan.

Surgery Today
|September 22, 2005
PubMed
Summary

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Laparoscopic purse-string suturing for esophagojejunostomy is simplified using the Endostitch device. This technique ensures secure anvil placement, improving anastomosis outcomes in patients after total gastrectomy.

Area of Science:

  • Gastrointestinal surgery
  • Minimally invasive procedures
  • Surgical techniques

Background:

  • Esophagojejunostomy requires secure anvil fixation at the esophageal stump.
  • Laparoscopic anvil placement using conventional methods presents challenges with purse-string suturing and risk of loosening.

Purpose of the Study:

  • To present a simple and effective technique for laparoscopic purse-string suturing of the esophageal stump using the Endostitch device.
  • To evaluate the feasibility and outcomes of this technique in patients undergoing esophagojejunostomy.

Main Methods:

  • Laparoscopic anvil placement was performed in 10 patients undergoing esophagojejunostomy after total gastrectomy.
  • The Endostitch device was used to place approximately 12 encircling purse-string sutures after esophageal lumen expansion.

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  • Anvil fixation was achieved with forceps support, and sutures were ligated with tension applied extracorporeally.

    • Main Results:

    • The average time for anvil placement was approximately 8 minutes.
    • Favorable ring formation following anastomosis was observed in all 10 patients.
    • The technique demonstrated simplicity and effectiveness in clinical application.

    Conclusions:

    • The Endostitch device offers a simple and effective solution for laparoscopic purse-string suturing during esophagojejunostomy.
    • This technique facilitates secure anvil placement, contributing to successful anastomosis in patients undergoing total gastrectomy.