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Published on: August 21, 2021
A simple and safe method for gastrojejunostomy in laparoscopic distal gastrectomy using the hemidouble-stapling
Takeshi Omori1, Tsukasa Oyama, Hiroki Akamatsu
1Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka, Japan. ohmori@oph.gr.jp
Digestive Surgery
|January 14, 2010
Summary
A novel technique for laparoscopic gastrojejunostomy in distal gastrectomy simplifies reconstruction. This method avoids purse-string sutures, enhancing safety and cosmesis in gastric cancer surgery.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic distal gastrectomy with Roux-en-Y reconstruction is standard for gastric cancer.
- Creating a secure and efficient gastrojejunal anastomosis is crucial.
- Existing techniques may involve complex steps like purse-string sutures.
Purpose of the Study:
- To present a straightforward technique for intracorporeal circular-stapled gastrojejunostomy.
- To detail the application of this method in laparoscopic distal gastrectomy.
- To highlight its advantages in Roux-en-Y reconstruction.
Main Methods:
- Gastrotomy creation and anvil insertion into the anterior gastric wall.
- Gastric transection using linear staplers for distal gastrectomy.
- Intracorporeal gastrojejunostomy via the hemidouble-stapling technique with transumbilical instrument manipulation.
Main Results:
- Successful gastrojejunostomies in 20 gastric cancer patients.
- Zero instances of anastomotic leakage or stenosis.
- No perioperative mortality observed in the study cohort.
Conclusions:
- The described technique for gastrojejunostomy is safe and simple.
- Eliminates the need for purse-string sutures, reducing complexity.
- Offers improved cosmesis through a transumbilical approach.