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Laparoscopic Total Gastrectomies Feasible, Quick And Safe
A DGReview of :"The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer"
Surgical Endoscopy
03/11/2002
By David Loshak
Laparoscopically assisted total gastrectomies can be a minimally invasive cure for early gastric cancer if patients are carefully chosen.
These surgeries are not as difficult as supposed, say surgeons at Gunma University, Maebashi, Japan. They report that they were able to complete four such procedures quickly and without any serious complications.
The surgeons noted that gastric cancer had been treated with laparoscopic gastrectomy in Japan in recent years but seldom with laparoscopic or laparoscopically assisted total gastrectomy because that technique was considered difficult.
The surgeons performed laparoscopically assisted total gastrectomies with jejunal interpositions on four patients with early gastric cancer in the upper portion of the stomach. In each case, four surgical ports were inserted into the abdomen. The stomach was lifted to the abdominal wall with newly developed retraction tubes. Gastric arteries were divided using ultrasonically activated coagulating shears and ligated with ligation forceps.
A total gastrectomy reconstruction was then performed by jejunal interposition through a small transverse laparotomy. Circular staplers were used to make an esophagojejunostomy and a jejunoduodenostomy.
The mean operating time was six hours and six minutes. Blood loss was 236 millilitres.
All patients were pain-free and ambulatory after the operations. The mean postoperative hospital stay was 16 days.
Surgical Endoscopy 2002; DOI: 10.1007/s00464-001-8219-2.
"The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer"
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