Related Experiment Video
Updated: Jun 18, 2026
Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
Published on: October 31, 2025
Gasless laparoscopic distal gastrectomy with Roux-en-Y reconstruction
Yoshinori Hosoya1, Alan Lefor, Masanobu Hyodo
1Department of Surgery, Jichi Medical University, Tochigi, Japan. hosoyo@jichi.ac.jp
Background/Aims:
Laparoscopic-assisted distal gastrectomy (LADG) is a minimally invasive procedure for patients with gastric carcinoma. We have previously reported gasless LADG with a Billroth-I reconstruction using a 5-7cm minilaparotomy. We modified the technique for gasless LADG to include a Roux-en Y reconstruction and to expand the indications for its use.
Methodology:
A total of 40 patients with early stage gastric tumors (T1 n=38, T2 n=2) underwent this procedure. Following gasless laparoscopic distal gastrectomy with lymph node dissection, a jejunum to greater curvature of the gastric remnant anastomosis was performed using an intracorporeal laparoscopic stapled method. The jejuno-jejunal anastomosis was performed using a hand-sewn technique under direct vision through a mini-laparotomy.
Results:
The mean surgical time (n=40) was 222 min, estimated blood loss 101 ml, and the mean number of lymph nodes harvested was 21. There were no postoperative complications such as bleeding, leak, or cardio-pulmonary dysfunction. Mean body weight loss was 3.9 kg, and there is no evidence of recurrence during a mean followup of 14 months.
Conclusions:
Gasless LADG with Roux-en-Y reconstruction is a feasible, novel procedure for a minimally invasive approach to gastric cancer.
