Skip to main content

Advertisement

SpringerLink
Log in

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

  • Innovative Surgical Techniques Around the World
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

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.

Methods

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.

Results

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%).

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

LDG:

Laparoscopic distal gastrectomy

LTG:

Laparoscopic total gastrectomy

LPG:

Laparoscopic proximal gastrectomy

PSD:

Purse-string suturing device

EGJ:

Esophagogastric junction

References

  1. Kitano S, Iso Y, Moriyama M et al (1994) Laparoscopy assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148

    CAS  PubMed  Google Scholar 

  2. Ohtani H, Tamamori Y, Noguchi K et al (2011) Meta-analysis of laparoscopy-assisted and open distal gastrectomy for gastric cancer. J Surg Res 171:479–485

    Article  PubMed  Google Scholar 

  3. Katai H, Sasako M, Fukuda H et al (2010) Safety and feasibility of laparoscopic-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer 13:238–244

    Article  PubMed  Google Scholar 

  4. Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14:101–112

    Article  Google Scholar 

  5. Japanese Gastric Cancer Association (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123

    Article  Google Scholar 

  6. Inaba K, Satoh S, Ishida Y et al (2010) Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg 211:e25–29

    Article  PubMed  Google Scholar 

  7. Yamamoto M, Zaima M, Yamamoto H et al (2014) A modified overlap method using a linear stapler for intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. Hepatogastroenterology 61:543–548

    PubMed  Google Scholar 

  8. Morimoto M, Kitagami H, Hayakawa T et al (2014) The overlap method is a safe and feasible for esophagojejunostomy after laparoscopic-assisted total gastrectomy. World J Surg Oncol 12:392

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kim HS, Kim MG, Kim BS et al (2013) Comparison of totally laparoscopic total gastrectomy and laparoscopic-assisted total gastrectomy methods for the surgical treatment of early gastric cancer near the gastroesophageal junction. J Laparoendosc Adv Surg Tech A 23:204–210

    Article  PubMed  Google Scholar 

  10. Nagai E, Ohuchida K, Nakata K et al (2013) Feasibility and safety of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy: inverted T-shaped anastomosis using linear staplers. Surgery 153:732–738

    Article  PubMed  Google Scholar 

  11. Bracale U, Marzano E, Nastro P et al (2010) Side-to-side esophagojejunostomy during totally laparoscopic total gastrectomy for malignant disease: a multicenter study. Surg Endosc 24:2475–2479

    Article  PubMed  Google Scholar 

  12. Ebihara Y, Okushiba S, Kawarada Y et al (2013) Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy. Langenbecks Arch Surg 398:475–479

    Article  PubMed  PubMed Central  Google Scholar 

  13. Tsunoda S, Okabe H, Obama K et al (2014) Short-term outcomes of totally laparoscopic total gastrectomy: experience with the first consecutive 112 cases. World J Surg 38:2662–2667. doi:10.1007/s00268-014-2611-2

    Article  PubMed  Google Scholar 

  14. Sakuramoto S, Kikuchi S, Futawatari N et al (2010) Technique of esophagojejunostomy using transoral placement of the pretilted anvil head after laparoscopic gastrectomy for gastric cancer. Surgery 147:742–747

    Article  PubMed  Google Scholar 

  15. Zuiki T, Hosoya Y, Kaneda Y et al (2013) Stenosis after use of the double-stapling technique for reconstruction after laparoscopy-assisted total gastrectomy. Surg Endosc 27:3683–3689

    Article  PubMed  Google Scholar 

  16. Takiguchi S, Sekimoto M, Fujiwara Y et al (2005) A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis. Surg Today 35:896–899

    Article  PubMed  Google Scholar 

  17. Omori T, Oyama T, Mizutani S et al (2009) A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg 197:e13–17

    Article  PubMed  Google Scholar 

  18. Nunobe S, Hiki N, Tanimura S et al (2011) Three-step esophagojejunal anastomosis with atraumatic anvil insertion technique after laparoscopic total gastrectomy. J Gastrointest Surg 15:1520–1525

    Article  PubMed  Google Scholar 

  19. Usui S, Nagai K, Hiranuma S et al (2008) Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument “Endo-PSI (II)” and circular stapler. Gastric Cancer 11:233–237

    Article  PubMed  Google Scholar 

  20. Lee JH, Ahn SH, Park DJ et al (2012) Laparoscopic total gastrectomy with D2 lymphadenectomy for advanced gastric cancer. World J Surg 36:2394–2399. doi:10.1007/s00268-012-1669-y

    Article  PubMed  Google Scholar 

  21. Inokuchi M, Otsuki S, Fujimori Y et al (2015) Systematic review of anastomotic complications of esophagojejunostomy after laparoscopic total gastrectomy. World J Gastroenterol 21(32):9656–9665

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastric Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, Japan

    Keisuke Okuno, Kentaro Gokita, Toshiro Tanioka, Norihito Ogawa, Sho Otsuki, Mikito Inokuchi & Kazuyuki Kojima

  2. Department of Mechano-Micro Engineering, Tokyo Institute of Technology, Tokyo, Japan

    Toshio Takayama

Authors
  1. Keisuke Okuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kentaro Gokita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshiro Tanioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Norihito Ogawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sho Otsuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mikito Inokuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Toshio Takayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kazuyuki Kojima
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keisuke Okuno.

Ethics declarations

Conflicts of interest

None.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (WMV 121710 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okuno, K., Gokita, K., Tanioka, T. et al. Esophagojejunostomy Using the Purse-String Suturing Device After Laparoscopic Total or Proximal Gastrectomy for Gastric Cancer. World J Surg 41, 2605–2610 (2017). https://doi.org/10.1007/s00268-017-4033-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-017-4033-4

Keywords

Search

Navigation