Laparoscopic Distal Gastrectomy (Billroth II) with Transrectal Specimen Extraction (GC-NOSES III)

Abstract

At present, laparoscopic gastric tumor surgery requires an incision of about 4–6 cm in length to extract the specimen, which also partially offsets the minimally invasive advantages of laparoscopic gastric tumor surgery. With the continuous exploration of surgeons, NOSES came into being and broke through the limitations and restraints of abdominal wall incision in traditional laparoscopic surgery. Laparoscopic distal gastrectomy with transrectal specimen extraction is mainly applicable to male gastric cancer patients and some female patients having small specimen size of the tumor, within stage T3 and without serosal infiltrating. Except that the method of specimen extracting is different from that of traditional laparoscopic surgery, the extent of gastrointestinal resection and lymph node dissection and dissecting plane during the surgery are consistent with traditional laparoscopic surgery. The operating characteristics are as follows: perform radical resection of gastric cancer and digestive tract anastomosis under laparoscope with an incision in the upper rectum, and remove the specimen through the rectum and anus. This procedure requires the surgeon to fully understand the indications, and the doctor and patient’s acceptance on the risk of surgery should be evaluated.