Surgical Endoscopy

, Volume 29, Issue 11, pp 3386–3391 | Cite as

Surgical outcomes of intracorporeal circular-stapled esophagojejunostomy using modified over-and-over suture technique in laparoscopic total gastrectomy

  • Takeru MatsudaEmail author
  • Takeshi Iwasaki
  • Masaaki Mitsutsuji
  • Kenro Hirata
  • Yoko Maekawa
  • Daisuke Tsugawa
  • Yutaka Sugita
  • Etsuji Shimada
  • Yoshihiro Kakeji
Dynamic Manuscript



Esophagojejunostomy in laparoscopic total gastrectomy (LTG) is a technically demanding procedure. Although several methods have been reported to date, none is considered consistently reliable. We developed a simple method for intracorporeal circular-stapled esophagojejunostomy using a modified over-and-over suture technique. The surgical outcomes of our technique were evaluated in comparison with those of open total gastrectomy (OTG).


From April 2012 to August 2014, reconstruction using this method in LTG was performed for 21 consecutive patients with gastric cancer (LTG group). Their surgical outcomes were compared with those of 27 patients with gastric cancer who underwent OTG without splenectomy (OTG group) between January 2011 and April 2014.


Estimated blood loss was significantly lower, and the postoperative hospital stay was significantly shorter in the LTG group than in the OTG group. The operating time and the number of harvested lymph nodes were similar between the two groups. The incidence of overall complications did not differ significantly between the two groups. Anastomotic leakage developed in one of the 21 patients in the LTG group and in two of the 27 patients in the OTG group. Anastomotic stenosis was observed in one patient in the LTG group.


We consider this method as simple and feasible for most laparoscopic surgeons with basic laparoscopic suturing skills. This method might help LTG to become an accepted standard surgical option for treatment of patients with gastric cancer.


Esophagojejunostomy Laparoscopy Gastric cancer 



Takeru Matsuda, Takeshi Iwasaki, Masaaki Mitsutsuji, Kenro Hirata, Yoko Maekawa, Daisuke Tsugawa, Yutaka Sugita, Etsuji Shimada, and Yoshihiro Kakeji have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (WMV 51803 kb)

Supplementary material 2 (WMV 44959 kb)

Supplementary material 3 (WMV 35646 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Takeru Matsuda
    • 1
    Email author
  • Takeshi Iwasaki
    • 1
  • Masaaki Mitsutsuji
    • 1
  • Kenro Hirata
    • 1
  • Yoko Maekawa
    • 1
  • Daisuke Tsugawa
    • 1
  • Yutaka Sugita
    • 1
  • Etsuji Shimada
    • 1
  • Yoshihiro Kakeji
    • 2
  1. 1.Department of SurgeryNational Hospital Organization Kobe Medical CenterKobeJapan
  2. 2.Division of Gastrointestinal Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan

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