Laparoscopic Billroth-II gastrectomy

Although the use of laparoscopic techniques in gastric surgery had become a focus in upper gastrointestinal surgery, standardized procedures have not yet been developed. The purpose of the study was to develop a standardized technique for laparoscopic Billroth-II resection in a cadaver model. End points were intraoperative complications and patency of the gastro jejunostomy. Laparoscopic partial stomach resection was performed in seven cadavers. The specimen was removed through an enlarged trocar incision. The first part of the jejunum was temporarily taken out through the same incision and a side-to-side jejuno-jejunostomy created. The gastrojejunostomy was stapled intracorporally. After surgery, all cadavers underwent autopsy. No lesions of intraabdominal organs were found, and the gastrojejunostomy was patent with correct stapling. No major intraoperative complications were recorded. Using the described technique, a laparoscopic Billroth-II operation can safely be accomplished. The technique has been successfully performed in three patients in the last month.