Abstract
Laparoscopic gastrectomy is a widely used minimally invasive technique for the treatment of gastric cancer. Since the introduction of extracorporeal reconstruction through a minilaparotomy in laparoscopy-assisted gastrectomy, efforts have been made to establish techniques for intracorporeal reconstruction in both laparoscopic distal gastrectomy (LDG) and laparoscopic total gastrectomy (LTG). In LDG, linear staplers are preferable to circular staplers for the creation of the gastroduodenostomy or gastrojejunostomy, and both linear and circular staplers have a role in LTG. These techniques have had acceptable surgical outcomes as described in the literature. We use linear staplers for reconstruction with the advantage of easier handling in a limited space and a better operative view during the anastomosis. In this chapter, technical tips and pitfalls of intracorporeal reconstruction in LDG and LTG are reported. The reconstruction-related short-term outcomes in our institution are described.
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References
Jeong O, Park YK. Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer. 2011;11:69–77.
Kitano S, Shiraishi N. Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc. 2004;18:182–5.
Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146–8.
Viñuela EF, Gonen M, Brennan MF, et al. Laparoscopic versus open distal gastrectomy for gastric cancer: a meta-analysis of randomized controlled trials and high-quality nonrandomized studies. Ann Surg. 2012;255:446–56.
Goh P, Tekant Y, Kum C, et al. Totally intra-abdominal laparoscopic Billroth II gastrectomy. Surg Endosc. 1992;6:160.
Kanaya S, Gomi T, Momoi H, et al. Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg. 2002;195:284–7.
Okabe H, Obama K, Tsunoda S, et al. Advantage of completely laparoscopic gastrectomy with linear stapled reconstruction: a long-term follow-up study. Ann Surg. 2014;259:109–16.
Kanaya S, Kawamura Y, Kawada H, et al. The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy. Gastric Cancer. 2011;14:365–71.
Hosogi H, Kanaya S. Intracorporeal anastomosis in laparoscopic gastric cancer surgery. J Gastric Cancer. 2012;12:133–9.
Okabe H, Tsunoda S, Tanaka E, et al. Is laparoscopic total gastrectomy a safe operation? A review of various anastomotic techniques and their outcomes. Surg Today. 2015;45:549–58.
Kinoshita T, Shibasaki H, Oshiro T, et al. Comparison of laparoscopy-assisted and total laparoscopic Billroth-I gastrectomy for gastric cancer: a report of short-term outcomes. Surg Endosc. 2011;25:1395–401.
Kanaji S, Harada H, Nakayama S, et al. Surgical outcomes in the newly introduced phase of intracorporeal anastomosis following laparoscopic distal gastrectomy is safe and feasible compared with established procedures of extracorporeal anastomosis. Surg Endosc. 2014;28:1250–5.
Kim MG, Kawada H, Kim BS, et al. A totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG) for improvement of the early surgical outcomes in high BMI patients. Surg Endosc. 2011;25:1076–82.
UICC International Union Against Cancer. TNM classification of malignant tumours. 7th ed. New York: Wiley; 2009. p. 73–7.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.
Kanaya S, Haruta S, Kawamura Y, et al. Video: laparoscopy distinctive technique for suprapancreatic lymph node dissection: medial approach for laparoscopic gastric cancer surgery. Surg Endosc. 2011;25:3928–9.
Inaba K, Satoh S, Ishida Y, et al. Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg. 2010;211:e25–9.
Shinohara T, Kanaya S, Yoshimura F, et al. A protective technique for retraction of the liver during laparoscopic gastrectomy for gastric adenocarcinoma: using a Penrose drain. J Gastrointest Surg. 2011;15:1043–8.
Hosogi H, Kanaya S, Nomura H, et al. Setting the stomach transection line based on anatomical landmarks in laparoscopic distal gastrectomy. J Gastric Cancer. 2015;15:53–7.
Ballesta-Lopez C, Bastida-VilaX CM, et al. Laparoscopic Billroth II distal subtotal gastrectomy with gastric stump suspension for gastric malignancies. Am J Surg. 1996;171:289–92.
Kim DG, Choi YY, An JY, et al. Comparing the short-term outcomes of totally intracorporeal gastroduodenostomy with extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer: a single surgeon’s experience and a rapid systematic review with meta-analysis. Surg Endosc. 2013;27:3153–61.
Ohashi M, Iwanaga T, Ohinata R, et al. A novel procedure for Roux-en-Y reconstruction following laparoscopy-assisted distal gastrectomy: transoral placement of anvil and intracorporeal gastrojejunostomy via umbilical mini-laparotomy. Gastric Cancer. 2011;14:188–93.
Omori T, Oyama T, Akamatsu H, et al. A simple and safe method for gastrojejunostomy in laparoscopic distal gastrectomy using the hemidouble-stapling technique: efficient purse-string stapling technique. Dig Surg. 2009;26:441–5.
Kinoshita T, Oshiro T, Ito K, et al. Intracorporeal circular-stapled esophagojejunostomy using handsewn purse-string suture after laparoscopic total gastrectomy. Surg Endosc. 2010;24:2908–12.
Kim HI, Cho I, Jang DS, et al. Intracorporeal esophagojejunostomy using a circular stapler with a new purse-string suture technique during laparoscopic total gastrectomy. J Am Coll Surg. 2013;216:e11–6.
Omori T, Oyama T, Mizutani S, et al. A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg. 2009;197:e13–7.
Jeong O, Park YK. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (Orvil) after laparoscopic total gastrectomy. Surg Endosc. 2009;23:2624–30.
Uyama I, Sugioka A, Fujita J, et al. Laparoscopic total gastrectomy with distal pancreatosplenectomy and d2 lymphadenectomy for advanced gastric cancer. Gastric Cancer. 1999;2:230–4.
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Hosogi, H., Sakai, Y., Kanaya, S. (2019). Intracorporeal Reconstruction in Laparoscopic Gastrectomy. In: Noh, S., Hyung, W. (eds) Surgery for Gastric Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45583-8_12
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DOI: https://doi.org/10.1007/978-3-662-45583-8_12
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