title: A simple biangulation stapling technique for large anastomoses in gastric surgery.
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.
authors.affiliation: Department of Tumor Surgery, Kochi Medical School, Nankoku, Japan. kobayasm@kochi-ms.ac.jp
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.forename: Ken
authors.initials: K
authors.lastname: Okamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Keijiro
authors.initials: K
authors.lastname: Araki
mesh_terms: D000714:Anastomosis, Surgical; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D013274:Stomach Neoplasms / Q000601:surgery*; D017792:Surgical Stapling / Q000379:methods*; D013537:Sutures