World Journal of Surgery

, Volume 41, Issue 10, pp 2605–2610 | Cite as

Esophagojejunostomy Using the Purse-String Suturing Device After Laparoscopic Total or Proximal Gastrectomy for Gastric Cancer

  • Keisuke OkunoEmail author
  • Kentaro Gokita
  • Toshiro Tanioka
  • Norihito Ogawa
  • Sho Otsuki
  • Mikito Inokuchi
  • Toshio Takayama
  • Kazuyuki Kojima
Innovative Surgical Techniques Around the World



Performing a safe esophagojejunostomy is important for the standardization of laparoscopic total gastrectomy. We have performed intracorporeal esophagojejunostomy by a circular stapler using the purse-string suturing device that we co-developed. The advantage of this device is that it makes use of the same surgical procedure as open surgery, but it does not depend on the surgeon’s technical skills since this device does not require the laparoscopic hand-sewn technique. Furthermore, we have also adapted this device for double-tract reconstruction after laparoscopic proximal gastrectomy. In this study, we present the surgical procedures and postoperative short-term outcomes that were obtained using this novel technique.


We enrolled 94 patients that underwent intracorporeal esophagojejunostomy by circular stapler using our device after laparoscopic total or proximal gastrectomy for gastric cancer between November 2009 and October 2016.


Postoperative complications related to esophagojejunostomy were due to anastomotic stenosis in two cases (2.1%) and leakage of the jejunum stump in one case (1.1%).


Intracorporeal esophagojejunostomy by circular stapler using the purse-string suturing device is safe and feasible. This method can be one of the standard procedures for performing intracorporeal esophagojejunostomy.


Gastric Cancer Circular Stapler Laparoscopic Total Gastrectomy Endoscopic Balloon Dilation Laparoscopic Distal Gastrectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Laparoscopic distal gastrectomy


Laparoscopic total gastrectomy


Laparoscopic proximal gastrectomy


Purse-string suturing device


Esophagogastric junction


Compliance with ethical standards

Conflicts of interest


Supplementary material

Supplementary material 1 (WMV 121710 kb)


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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Keisuke Okuno
    • 1
    Email author
  • Kentaro Gokita
    • 1
  • Toshiro Tanioka
    • 1
  • Norihito Ogawa
    • 1
  • Sho Otsuki
    • 1
  • Mikito Inokuchi
    • 1
  • Toshio Takayama
    • 2
  • Kazuyuki Kojima
    • 1
  1. 1.Department of Gastric SurgeryTokyo Medical and Dental UniversityTokyoJapan
  2. 2.Department of Mechano-Micro EngineeringTokyo Institute of TechnologyTokyoJapan

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