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Multi-Vector Retraction Using Extracorporeally Suspended Retractor in Single Port Total Gastrectomy
Kengo Hayashi1, Noriyuki Inaki1, Jun Kinoshita1
1Department of Gastrointestinal Surgery, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
Asian Journal of Endoscopic Surgery
|August 25, 2025
Summary
Single-incision laparoscopic surgery (SILS) for total gastrectomy is feasible using needle forceps and an adjustable retractor. This technique enhances cosmetic outcomes and reduces pain while ensuring oncologic safety.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Single-incision laparoscopic surgery (SILS) and needle forceps offer cosmetic benefits and reduced pain.
- Total gastrectomy presents technical challenges for SILS due to limited triangulation and lack of assistant support.
Observation:
- A 31-year-old woman with gastric cancer desired a cosmetically favorable procedure.
- A total gastrectomy with D2 lymphadenectomy was performed using SILS with a 3-mm needle forceps.
Findings:
- An adjustable organ retractor enabled multidirectional traction, maintaining adequate exposure without an assistant port.
- This technique facilitated stable visualization and safe, oncologically appropriate dissection.
- The patient experienced an uneventful recovery, with no major complications and remained recurrence-free at 3 years.
Implications:
- This technical modification allows for safe SILS total gastrectomy using needle forceps and an adjustable organ retractor.
- The approach enhances cosmetic results and patient recovery in gastric cancer surgery.
- Further studies may explore the broader application of this technique in complex laparoscopic procedures.
