Radical Lymph Node Dissection Along the Proximal Splenic Artery During Laparoscopic Gastrectomy for Gastric Cancer...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastric Cancer Treatment

Background:

• Laparoscopic lymph node dissection (LND) is now safe for gastric cancer.
• Suprapancreatic LND requires meticulous dissection around the celiac artery (CA).
• A novel left lateral approach was developed for improved LND around the proximal splenic artery (SA).

Purpose of the Study:

• To describe a new technique for laparoscopic lymph node dissection (LND) around the celiac artery (CA) in gastric cancer.
• To evaluate the safety and efficacy of a left lateral approach for deep LND along the proximal splenic artery (SA).

Main Methods:

• The procedure involves LND from the patient's right side, followed by a left lateral approach.
• Dissection proceeds along the splenic artery (SA), preserving the posterior pancreatic fascia.
• Deep lymph node dissection around the left side of the celiac artery (CA) is achieved.

Main Results:

• The technique was performed on ten patients without operative complications (grade II or higher).
• Lymph nodes around the proximal splenic artery (SA) and left celiac artery (CA) were successfully removed in all cases.
• Early identification and preservation of the dorsal layer were achieved.

Conclusions:

• This left lateral approach enables early identification of the dorsal layer during deep LND around the celiac artery (CA).
• The technique facilitates radical lymph node dissection along the proximal splenic artery (SA).
• This method enhances safety and thoroughness in laparoscopic gastric cancer surgery.