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

World Journal of Surgery volume 41, pages 2605–2610 (2017)Cite this article

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.

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Abbreviations

LDG:

Laparoscopic distal gastrectomy

LTG:

Laparoscopic total gastrectomy

LPG:

Laparoscopic proximal gastrectomy

PSD:

Purse-string suturing device

EGJ:

Esophagogastric junction

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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
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  2. Kentaro Gokita
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  3. Toshiro Tanioka
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  4. Norihito Ogawa
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  5. Sho Otsuki
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  6. Mikito Inokuchi
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  7. Toshio Takayama
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  8. Kazuyuki Kojima
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Corresponding author

Correspondence to Keisuke Okuno.

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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

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

Keywords

  • Gastric Cancer
  • Circular Stapler
  • Laparoscopic Total Gastrectomy
  • Endoscopic Balloon Dilation
  • Laparoscopic Distal Gastrectomy