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Laparoscopic partial gastric transection and devascularization in order to enhance its flow.
Federico Cuenca-Abente1, Ahmad Assalia, Gianmattia del Genio
1Division of Laparoscopic Surgery, Mount Sinai Minimally Invasive Surgery Center (MSMISC), Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA. federico@u.washington.edu
Annals of Surgical Innovation and Research
|July 9, 2008
Summary
Laparoscopic gastric devascularization and partial transection safely increases stomach blood flow. This procedure promotes neovascularization, potentially reducing esophagogastric fistula formation after cancer surgery.
Area of Science:
- Surgical oncology
- Gastrointestinal surgery
- Vascular surgery
Background:
- Esophagogastric fistula is a common complication after esophagectomy for cancer.
- Gastric ischemia is a primary factor contributing to fistula development.
- Improving gastric fundus vascularity may mitigate fistula risk.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic gastric devascularization and partial transection.
- To assess the impact of this procedure on gastric fundus vascular flow.
- To investigate the potential of enhanced vascularity in preventing fistulas.
Main Methods:
- Eight pigs underwent laparoscopic gastric devascularization and mobilization.
- Vascular flow was measured using laser Doppler before and after the procedure.
- Gastric fundus samples were evaluated histopathologically after three weeks.
Main Results:
- Macroscopic and microscopic evaluations revealed neovascularization in the gastric fundus.
- Laser Doppler measurements confirmed increased vascular flow.
- Histopathological findings correlated with vascular flow measurements.
Conclusions:
- Laparoscopic gastric devascularization and partial transection is a safe surgical approach.
- The procedure significantly enhances gastric vascular flow within three weeks.
- This technique shows promise in reducing the incidence of esophagogastric fistula formation.
