Laparoscope-assisted Billroth I gastrectomy

We performed a distal gastrectomy, including regional lymph node dissection, under laparoscopic observation followed by Billroth I. (B-I) anastomosis using autosuture in five patients with early gastric cancer. We had previously evaluated the technique for reconstructive surgery in animal experiments. Our method was determined to be safe without marked deformation caused by applying the autosuture for gastroduodenostomy. The wound was small, and an almost closed operation was possible. Furthermore, unlike endoscopic mucosal resection or laparoscopic partial resection, a major part of the regional lymph nodes can be extirpated; the lesion site may not be limited to the half of the stomach on the distal side. Our method of distal gastrectomy under laparoscopy is a potentially useful limited operation in patients with early gastric cancer.