Modified side overlap esophagogastrostomy after laparoscopic proximal gastrectomy

Area of Science:

• Gastrointestinal Surgery
• Surgical Reconstruction
• Minimally Invasive Procedures

Background:

• Proximal gastrectomy is a surgical procedure for gastric cancer.
• Esophagogastrostomy reconstruction is crucial after proximal gastrectomy.
• The Side Overlap with Fundoplication by Yamashita (SOFY) method has been used for reconstruction.

Purpose of the Study:

• To describe the technical details of the modified SOFY (mSOFY) method.
• To evaluate the treatment outcomes of the mSOFY method after laparoscopic proximal gastrectomy.
• To establish mSOFY as a safe and feasible reconstruction technique.

Main Methods:

• Laparoscopic proximal gastrectomy followed by mSOFY reconstruction.
• Dissection of stomach along the short axis and esophagus left/right.
• Dissection of diaphragmatic crus for gastric elevation.
• SOFY check for >5 cm esophageal overlap.
• Anastomosis using a 45 mm linear stapler.
• Suture fixation of esophagus, remnant stomach, and diaphragmatic crus.

Main Results:

• The mSOFY technique involves specific dissection and fixation steps.
• The pseudofornix acts as a reflux prevention mechanism.
• The modified method demonstrated favorable treatment outcomes.
• The procedure was found to be safe and feasible.

Conclusions:

• The modified SOFY (mSOFY) method is a safe and feasible reconstruction technique.
• mSOFY offers improved outcomes compared to previous methods.
• This technique is suitable for patients undergoing laparoscopic proximal gastrectomy.