Single port Billroth I gastrectomy.

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Laparoscopic Techniques

Background:

• Single-port surgery is advancing, enabling more complex procedures.
• Benign tumors found incidentally, such as gastric submucosal lipoma, require surgical resection.
• Cholelithiasis can coexist with gastric pathologies, necessitating combined surgical approaches.

Purpose of the Study:

• To describe a technique for single-port Billroth I gastrectomy.
• To demonstrate the feasibility of a hand-sewn intracorporeal anastomosis in this setting.
• To report the successful resection of a benign gastric tumor using this approach.

Main Methods:

• Single-port Billroth I gastrectomy and cholecystectomy performed via a transumbilical quadport.
• Utilized flexible-tipped camera and conventional instruments with a laparoscopic stapler for division.
• Created a two-layer, end-to-end, hand-sewn intracorporeal anastomosis using barbed sutures.

Main Results:

• The procedure involved mobilization, lymph node dissection, and resection of the tumor.
• A patent anastomosis without leak was confirmed intraoperatively via endoscopy.
• The patient was discharged on postoperative day 8 with no complications, tolerating a full diet.

Conclusions:

• Technological advancements, including flexible cameras and barbed sutures, facilitate complex single-port laparoscopic procedures.
• This technique enables intracorporeal hand-sewn anastomosis, expanding the possibilities of single-port surgery.
• With further experience, such advanced single-port techniques are expected to become more common.