Laparoscopic Total Gastrectomy with Transrectal Specimen Extraction (GC-NOSES VII)

Abstract

Laparoscopic total gastrectomy is mainly applicable to gastric cancer patients with lesions invading the body of the stomach, the upper and middle part of the stomach, or the gastroesophageal junction. In the NOSES, specimen is extracted through the natural orifice, while the basic laparoscopic operational steps are not changed. Except that the method of specimen extraction is different from that of conventional laparoscopic surgery, the gastrointestinal tract resection, the extent of lymph node dissection, the dissection plane of surgery, and digestive tract reconstruction are consistent with those of conventional laparoscopic surgery. Laparoscopic total gastrectomy with transanal specimen extraction (GC-NOSES VII) is a resection extraction NOSES procedure. The operating characteristics are as follows: radical resection of gastric cancer and digestive tract anastomosis under laparoscopy with an incision in the upper rectum and specimen extraction through the anus. The procedure conforms to the concept of minimally invasive surgery. Under the premise of conforming to the basic principles of cancer surgery, the surgical damage can be reduced by optimizing the surgical approach, improving the operational procedure, and preserving the structure and function of the abdominal wall, thereby reducing the influence on patients’ quality of life.