Skip to main content
Log in

Feasibility of Laparoscopic partial gastrectomy with sentinel node basin dissection in a porcine model

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

This study aimed to evaluate the technical feasibility and safety of laparoscopic partial full-thickness gastrectomy with extensive sentinel node basin (SB) dissection in a porcine model before its application to gastric cancer without lymph node metastasis.

Methods

A series of 10 pigs (30–37 kg) were used for a survival study approved by an animal use committee. The imaginary lesions were located in the greater curvature (n = 2), lesser curvature (n = 2), anterior wall (n = 2), posterior wall (n = 2), cardia (n = 1), and angle of the stomach (n = 1). The SBs were assumed to be located around each lesion in question. Laparoscopic partial gastrectomy and SB dissection were performed. Upper gastrointestinal series (UGIS) studies were performed with gastrograffin 5 days after the operation to detect possible stricture, leakage, and passage problems. The pigs were kept alive for 3 weeks, then killed.

Results

The procedure was completed for all the pigs. Nine gastric wedge resections and one segmental resection of the stomach with several SB dissections were performed. The mean operation time was 102 min (70–150 min). The postoperative mean weight gain was 3.19 kg. There was no perioperative morbidity or mortality. The UGIS studies failed to detect leakage and stricture, but all the pigs exhibited delayed gastric emptying. Necropsies did not detect procedure-related complications.

Conclusions

As shown by a pig model, laparoscopic limited gastrectomy with SB dissection appears to be safe and technically feasible.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Gould EA, Winship T, Philbin Ph, Kerr HH (1960) Observations on “sentinel lymph node” in cancer of the parotid. Cancer 13:77–78

    Article  PubMed  CAS  Google Scholar 

  2. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, Foshag LJ, Cochran AJ (1993) Technique details of intraoperative lymphatic mapping for early-stage melanoma. Arch Surg 127:392–399

    Google Scholar 

  3. Alex KC, Weaver D, Faorbaml KT, Ramlom Bs, Lrag DM (1993) Gamma-probe-guided lymph node localization in malignant melanoma. Surg Oncol 2:303–308

    Article  PubMed  CAS  Google Scholar 

  4. Hiratsuka M, Miyashiro I, Ishikawa O, Furukawa H, Motomura K, Ohigashi H, Kameyama M, Sasaki Y, Kabuto T, Ishiguro S, Imaoka S, Koyama H (2001) Application of sentinel node biopsy to gastric cancer surgery. Surgery 129:335–340

    Article  PubMed  CAS  Google Scholar 

  5. Kitagawa Y, Fujii H, Mukai M, Kubota T, Otani Y, Kitajima M (2001) Radio-guided sentinel node detection for gastric cancer. Br J Surg 89:604–608

    Article  Google Scholar 

  6. Hayashi H, Ochiai T, Mori M, Karube T, Suzuki T, Gunji Y, Hori S, Akutsu N, Matsubara H, Shimada H (2003) Sentinel lymph node mapping for gastric cancer using a dual procedure with dye- and gamma-probe-guided techniques. J Am Coll Surg 196:68–74

    Article  PubMed  Google Scholar 

  7. Kim MC, Kim HH, Jung GJ, Lee JH, Choi SR, Kang DY, Roh MS, Jeong JS (2004) Lymphatic mapping and sentinel node biopsy using 99 mTc tin colloid in gastric cancer. Ann Surg 239:383–387

    Article  PubMed  Google Scholar 

  8. Park DJ, Lee HJ, Lee HS, Kim WH, Kim HH, Lee KU, Choe KJ, Yang HK (2006) Sentinel node biopsy for cT1 and cT2a gastric cancer. Eur J Surg Oncol 32:48–54

    Article  PubMed  CAS  Google Scholar 

  9. Ajisaka H, Miwa K (2003) Micrometastasis in sentinel nodes of gastric cancer. Br J Cancer 89:676–680

    Article  PubMed  CAS  Google Scholar 

  10. Miwa K, Kinami S, Taniguchi K, Fushida S, Fujimura T, Nonomura A (2003) Mapping sentinel nodes in patients with early-stage gastric carcinoma. Br J Surg 90:178–182

    Article  PubMed  CAS  Google Scholar 

  11. Mochiki E, Kuwano H, Kamiyama Y, Aihara R, Nakabayashi T, Katoh H, Asao T, Oriuchi N, Endo K (2006) Sentinel lymph node mapping with technetium-99 m colloidal rhenium sulfide in patients with gastric carcinoma. Am J Surg 191:465–469

    Article  PubMed  Google Scholar 

  12. Lee JH, Ryu KW, Kook MC, Lee JY, Kim CG, Choi IJ, Kim SK, Jang S, Park SR, Kim YW, Nam BH, Bae JM (2008) Feasibility of laparoscopic sentinel basin dissection for limited resection in early gastric cancer. J Surg Oncol 98:331–335

    Article  PubMed  Google Scholar 

  13. Skoropad V, Berdow B, Zagrebin V (2005) Clinicopathological features and outcome of surgical treatment of 149 patients with early (pT1) gastric cancer. Oncologie 28:247–252

    Article  Google Scholar 

  14. Gotoda T (2007) Endoscopic resection of early gastric cancer. Gastric Cancer 10:1–11

    Article  PubMed  Google Scholar 

  15. Ohgami M, Otani Y, Kumai K, Kubota T, Kim YI, Kitajima M (1999) Curative laparoscopic surgery for early gastric cancer: five years experience. World J Surg 23:187–193

    Article  PubMed  CAS  Google Scholar 

  16. Yasuda K, Shiraishi N, Suematsu T, Yamaguchi K, Adachi Y, Kitano S (1999) Rate of detection of lymph node metastasis is correlated with the depth of submucosal invasion in early-stage gastric carcinoma. Cancer 85:2119–2123

    Article  PubMed  CAS  Google Scholar 

  17. Tonouch H, Mohri Y, Tanaka K, Kobayashi M, Ohmori Y, Kusunoki M (2005) Laparoscopic lymphatic mapping and sentinel node biopsies for early-stage gastric cancer: the cause of false negativity. World J Surg 29:418–421

    Article  Google Scholar 

  18. Aoyagi N, Ogata H, Kaniwa N, Uchiyama M, Yasuda Y, Tanioka Y (1992) Gastric emptying of tablets and granules in humans, dogs, pigs, and stomach-emptying controlled rabbits. J Pharm 8:1170–1174

    Google Scholar 

  19. Hossain M, Abramowitz W, Watrous BJ, Szpunar GJ, Ayres JW (1990) Gastrointestinal transit of nondisintegrating, nonerodible oral dosage forms in pigs. Pharm Res 7:1163–1166

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A085125).

Disclosures

Ju-Hee Lee, Moon-Soo Lee, Hyung Ho Kim, Do Joong Park, Kyoung Ho Lee, Ji-Yeon Hwang, Hyuk-Joon Lee, Han-Kwang Yang and Kuhn Uk Lee have no conflicts of interest or financial ties to disclosure.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hyung-Ho Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, JH., Lee, M.S., Kim, HH. et al. Feasibility of Laparoscopic partial gastrectomy with sentinel node basin dissection in a porcine model. Surg Endosc 25, 1070–1075 (2011). https://doi.org/10.1007/s00464-010-1318-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1318-1

Keywords

Navigation