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- Title
A new procedure with stomach-lifting techniques to simplify laparoscopy-assisted distal gastrectomy and extraperigastric lymph node dissection for gastric cancer.
- Authors
Tatsushi Suwa; Masashi Yoshida; Keisuke Kubota; Junko Kuroda; Masayoshi Sakuma; Masaki Kitajima
- Abstract
Abstract Laparoscopy-assisted gastrectomy with extraperigastric lymph node dissection for gastric cancer is a complicated procedure that generally requires advanced laparoscopic surgical skill. We devised a simplified but effective laparoscopic procedure that provides a better visual field to perform safe lymph node dissection more quickly. First, a mini-laparotomy is done and a clear visual field is created by pulling a mini-retractor to the right or left. The laparoscopic procedure is made easier and safer by taping the stomach body, and by using the fringe of an abdominal wall sealing device (Lapdisk) placed behind the stomach, and a scope holder for the snake-retractor. The lymph nodes along the common hepatic vessels, left gastric vessels, and celiac artery (extraperigastric lymph nodes) are then dissected laparoscopically. The suprapyloric and infrapyloric lymph nodes are dissected through the mini-laparotomy incision and gastroduodenostomy is done using an anastomotic device. We performed laparoscopy-assisted distal gastrectomy (LADG) in 70 patients with gastric carcinomas located in the distal stomach (mean body mass index: 24.3). The mean operating time was 170 min and blood loss was minimal. All patients recovered well with minimal pain and good postoperative quality of life. We conclude that our simple and practical procedure for LADG with extraperigastric lymph node dissection can be performed safely and easily.
- Subjects
LYMPH node surgery; LAPAROSCOPY; GASTRECTOMY; STOMACH surgery; STOMACH cancer; GASTRODUODENOSTOMY; POSTOPERATIVE care
- Publication
Surgery Today, 2009, Vol 39, Issue 1, p83
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-008-3780-0