Journal of Gastrointestinal Surgery

, Volume 22, Issue 4, pp 578–586 | Cite as

Right-Side Approach-Duet Totally Laparoscopic Distal Gastrectomy (R-Duet TLDG) Using a Three-Port to Treat Gastric Cancer

  • Ho Seok Seo
  • Kyo Young Song
  • Yoon Ju Jung
  • Ji Hyun Kim
  • Cho Hyun Park
  • Han Hong Lee
Original Article



Gastric cancer is commonly treated via minimally invasive surgery. The present study explored the feasibility of right-side approach-duet (R-duet) totally laparoscopic distal gastrectomy using a three-port compared with a four- or five-port.


A total of 251 patients who underwent curative totally laparoscopic distal gastrectomy for gastric cancer (72 R-duet, 74 four-port, and 105 five-port) at the Catholic Medical Center were enrolled. All operations were performed using conventional laparoscopic instruments. The clinicopathological characteristics, operative details, and postoperative short-term outcomes were analyzed retrospectively.


The clinicopathological characteristics did not differ significantly among the groups, except that the N stage was higher in the five-port group. The operating time was significantly longer in the four-port than the R-duet group (R-duet, four-port, and five-port 148.2 ± 30.7, 162.4 ± 30.6, and 159.9 ± 31.5 min, respectively; p = 0.024). The estimated blood loss did not differ significantly. Postoperatively, the times to flatus and to soft diet consumption and the hospital stay were significantly longer in the five-port group. The extent of postoperative complications did not differ among the groups.


R-duet totally laparoscopic distal gastrectomy is a reliable form of reduced-port surgery when used to treat gastric cancer; no special instruments are required.


Gastrectomy Laparoscopic surgery Minimally invasive surgery Reduced port surgery Stomach neoplasm 


Author Contributions

Ho Seok Seo, Kyo Young Song, Ji Hyun Kim, Yoon Ju Jung, Cho Hyun Park, and Han Hong Lee were responsible for the study’s conceptualization; Ho Seok Seo and Han Hong Lee for the formal analysis; Ho Seok Seo, Kyo Young Song, Ji Hyun Kim, Yoon Ju Jung, Cho Hyun Park, and Han Hong Lee for the investigation; Ji Hyun Kim and Yoon Ju Jung for the data acquisition; Ho Seok Seo, Kyo Young Song, Cho Hyun Park, and Han Hong Lee for the data interpretation; Ho Seok Seo and Han Hong Lee for the drafting; and all authors for the writing, review, critical editing, final approval, and agreement to be accountable.

Funding Information

This research was supported by grants from the National Research Foundation of Korea (nos. 2012R1A1A1043576 and 2015R1A1A1A05028000).

Compliance with Ethical Standards

The study was approved by the institutional review board of the ethics committee of the College of Medicine, Catholic University of Korea (approval no. KC17RESI0110). Patient records were anonymized and de-identified prior to analysis.

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

11605_2017_3575_MOESM1_ESM.docx (17 kb)
ESM 1 (DOCX 16 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2017

Authors and Affiliations

  • Ho Seok Seo
    • 1
  • Kyo Young Song
    • 1
  • Yoon Ju Jung
    • 1
  • Ji Hyun Kim
    • 1
  • Cho Hyun Park
    • 1
  • Han Hong Lee
    • 1
  1. 1.Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of MedicineCatholic University of KoreaSeoulSouth Korea

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