Feasibility of laparoscopic partial gastrectomy with sentinel node basin dissection in a porcine model

This study aimed to evaluate the technical feasibility and safety of laparoscopic partial full-thickness gastrectomy with extensive sentinel node basin (SB) dissection in a porcine model before its application to gastric cancer without lymph node metastasis.

A series of 10 pigs (30-37 kg) were used for a survival study approved by an animal use committee. The imaginary lesions were located in the greater curvature (n = 2), lesser curvature (n = 2), anterior wall (n = 2), posterior wall (n = 2), cardia (n = 1), and angle of the stomach (n = 1). The SBs were assumed to be located around each lesion in question. Laparoscopic partial gastrectomy and SB dissection were performed. Upper gastrointestinal series (UGIS) studies were performed with gastrograffin 5 days after the operation to detect possible stricture, leakage, and passage problems. The pigs were kept alive for 3 weeks, then killed.

The procedure was completed for all the pigs. Nine gastric wedge resections and one segmental resection of the stomach with several SB dissections were performed. The mean operation time was 102 min (70-150 min). The postoperative mean weight gain was 3.19 kg. There was no perioperative morbidity or mortality. The UGIS studies failed to detect leakage and stricture, but all the pigs exhibited delayed gastric emptying. Necropsies did not detect procedure-related complications.

As shown by a pig model, laparoscopic limited gastrectomy with SB dissection appears to be safe and technically feasible.