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Updated: Jun 8, 2026
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy
Chikara Kunisaki1, Hirochika Makino, Takashi Oshima
1Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57, Urafunecho, Minami-ku, Yokohama 232-0024, Japan. s0714@med.yokohama-cu.ac.jp
Background:
Laparoscopy-assisted total gastrectomy (LATG) is not a commonly performed procedure due to the surgical difficulty associated with reconstruction. Although various reconstruction methods have been reported, a standard technique has not yet been established. In this study, we compared the short-term outcomes of LATG reconstructed by mini-laparotomy and by the newly developed transorally inserted anvil (OrVil).
Methods:
From April 2006, a series of 45 patients underwent LATG. Of these, 15 were reconstructed by mini-laparotomy and 30 by OrVil. Short-term outcomes were compared between the two groups.
Results:
Operation time was significantly shortened and intraoperative blood loss significantly reduced by the use of OrVil. The postoperative course, including morbidity, did not differ between the two groups.
Conclusions:
LATG using OrVil for the treatment of early gastric cancer is a technically feasible surgical procedure with sufficient lymph node dissection, satisfactory early recovery, and acceptable morbidity. It will be necessary to perform this novel technique in a large number of patients to confirm its feasibility.