Abstract
We describe here a new technique for performing the large anastomosis between the jejunal pouch and the remnant stomach in patients undergoing proximal gastrectomy with jejunal pouch interposition. The biangulation method described in this report is a simpler technique than the existing triangulation anastomosis technique, requiring only two applications of a linear stapler. One row of staples forms the posterior wall of the anastomosis and the other forms the anterior wall. When used for jejunal pouch reconstruction after proximal gastrectomy in 12 cases of early gastric cancer, no evidence of anastomotic leakage or stenosis was apparent from barium meal studies or endoscopic examination. We find this biangulation technique to be a simple and safe procedure that is ideal for anastomoses of large diameter.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kobayashi M, Araki K, Okamoto K, Okabayashi T, Akimori T, Sugimoto T. Anti-reflux pouch-esophagostomy after proximal gastrectomy with jejunal pouch interposition reconstruction. Hepatogastroenterology. In press.
Takeshita K, Saito N, Saeki I, Honda T, Tani M, Kando F, Endo M. Proximal gastrectomy and jejunal pouch interposition for the treatment of early cancer in the upper third of the stomach: Surgical techniques and evaluation of postoperative function. Surgery 1997;121:278–286.
Tomita R, Fujisaki S, Tanjoh K, Fukuzawa M. A novel operative technique on proximal gastrectomy reconstructed by interposition of a jejunal J pouch with preservation of the vagal nerve and lower esophageal sphincter. Hepatogastroenterology 2001;48:1186–1191.
Heifetz C. Technique of single-layer end-to-end intestinal anastomosis by triangulation. Surg Clin N Am 1966;46:223–228.
McGinty CP. Update on stapled bowel anastomosis. Missouri Med 1979;76, 145–150,159.
Venkatesh KS, Morrison N, Larson DM, Ramanujam P. Triangulating stapling technique: An alternative approach to colorectal anastomosis. Dis Colon Rectum 1993;36:73–76.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kobayashi, M., Okabayashi, T., Namikawa, T. et al. A simple biangulation stapling technique for large anastomoses in gastric surgery. J Gastrointest Surg 10, 911–915 (2006). https://doi.org/10.1016/j.gassur.2005.12.008
Issue Date:
DOI: https://doi.org/10.1016/j.gassur.2005.12.008