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Related Experiment Videos

Total gastrectomy and oesophagojejunostomy with linear stapling devices.

B S Walther1, T Zilling, F Johnsson

  • 1Department of Surgery, Lund University, Sweden.

The British Journal of Surgery
|September 1, 1989
PubMed
Summary

This study introduces a new linear stapler technique for oesophagojejunostomy after total gastrectomy, improving speed and reliability. The method avoids the need for a purse-string suture and is independent of oesophageal lumen size.

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Area of Science:

  • Surgical Innovation
  • Gastrointestinal Surgery
  • Surgical Oncology

Background:

  • Traditional circular stapling for oesophagojejunostomy presents challenges, including the need for purse-string sutures and difficulties with narrow oesophagi, increasing rupture risk.
  • Total gastrectomy necessitates effective oesophagojejunostomy techniques to ensure patient safety and optimal outcomes.

Purpose of the Study:

  • To present and evaluate a novel technique for oesophagojejunostomy using two linear staplers.
  • To assess the safety, efficacy, and operative time of this new method compared to conventional approaches.

Main Methods:

  • A technique involving a small oesophageal incision and the use of GIA or PLC 50 linear staplers to create the oesophagojejunostomy.
  • The residual opening is closed with a linear stapler, and excess tissue is trimmed.

Related Experiment Videos

  • Fifteen patients underwent this procedure, with outcomes and anastomosis width assessed postoperatively.

    • Main Results:

    • The procedure was performed in 15 patients with a median age of 67 years, resulting in a median postoperative hospital stay of 10 days.
    • Anastomosis creation time averaged 12 minutes.
    • One case of leakage and one mortality were reported; three reoperations were required for obstruction, leakage, and exploration.
    • The median oesophagojejunal anastomosis width at 6 months was 32 mm.

    Conclusions:

    • Oesophagojejunostomy performed with two linear staplers offers a rapid and dependable anastomosis.
    • This technique is not limited by oesophageal lumen size and eliminates the need for a time-consuming purse-string suture.
    • The described method represents a viable alternative for oesophagojejunostomy in total gastrectomy procedures.