Overlapping Esophagojejunostomy Using a Linear Stapler in Laparoscopic Total or Proximal Gastrectomy

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Minimally Invasive Procedures

Background:

• Intracorporeal esophagojejunostomy during laparoscopic gastrectomy presents significant technical challenges.
• Existing methods carry risks of stapler-related intraoperative complications.

Purpose of the Study:

• To present an ingenious overlapping esophagojejunostomy method using a linear stapler.
• To demonstrate a technique that enhances ease, stability, and safety during laparoscopic gastrectomy.

Main Methods:

• A side-to-side esophagojejunostomy was performed using a linear stapler after esophageal and jejunal transection.
• Precise placement of sutures and guidance with a nasogastric tube (NGT) prevented anvil misinsertion.
• The anastomosis was secured by firing the linear stapler, followed by closure of the entry hole.

Main Results:

• Eleven patients successfully underwent the procedure.
• No anastomotic complications were observed in any of the patients.
• The technique proved to be easier and more stable compared to conventional methods.

Conclusions:

• The described overlapping esophagojejunostomy technique is safe and effective.
• This method simplifies the procedure and reduces the risk of complications.
• It offers a valuable alternative for intracorporeal esophagojejunostomy in laparoscopic gastrectomy.