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Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment

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Laparoscopy-assisted total gastrectomy: a simplified approach.

Kazuya Muguruma¹, Hiroaki Tanaka, Katsunobu Sakurai

¹1 Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.

International Surgery

|January 22, 2014

Summary

This study introduces a simplified technique for laparoscopy-assisted total gastrectomy (LATG) to improve anvil insertion during esophagojejunostomy. The modification facilitates the procedure, making it safer and more accessible for surgeons.

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Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Gastrointestinal Surgery

Background:

Laparoscopy-assisted total gastrectomy (LATG) with esophagojejunostomy is a complex procedure.
Challenges include difficult anvil insertion and potential oral injuries.
Standard techniques require advanced surgical skills for safe execution.

Purpose of the Study:

To present a simple modification for laparoscopic anvil insertion during LATG.
To reduce operative time and minimize complications associated with esophagojejunostomy.
To enhance the safety and accessibility of LATG for surgeons with varying skill levels.

Main Methods:

A semicircumferential esophagotomy is created on the anterior esophageal wall.
An OrVil anvil is laparoscopically inserted and secured with a suture.
The esophagus is transected, followed by a circular-stapled esophagojejunostomy using the hemidouble stapling technique.

Main Results:

The modified technique significantly reduced anvil placement time (average 5 min vs. 9 min).
All 40 procedures for gastric cancer were completed laparoscopically without complications.
No major complications or mortality were observed in the patient series.

Conclusions:

This simple modification effectively facilitates anvil insertion in LATG.
The technique enhances safety and ease of performing circular-stapled esophagojejunostomy.
It enables surgeons with less advanced skills to perform LATG procedures effectively.