title: Laparoscopy-assisted distal gastrectomy with 3-cm laparotomy, left hepatic lobe compression technique, and selection of automatic anastomosis device.
abstract: In this study, we performed laparoscopy-assisted distal gastrectomy (LADG) and lymph node dissection with an incision of 3 cm aiming at radical cure and low invasiveness. We introduce and discuss this technique of minilaparotomy and recommend a device for anastomosis. In LADG, a skin incision of 5cm or greater is made in order to pull out the stomach in other institutes. Whether function is distinctly better after laparoscopy-assisted surgery than after abdominal section has not been elucidated so far, so we should seek an aesthetic advantage. We have used a 3-cm abdominal wound to date. If the wound is smaller than this, the body of the SDH25 cannot be inserted, and currently a wound less than 3cm may thus not be possible. The shaft of the SDH is straight, making it easy to confirm the direction even through a laparoscope. The shaft of the anvil head of the PPCEEA is too long, so that when it is connected with the body through the 3-cm incision, it is necessary to draw it through the remnant stomach to a great extent.
authors.affiliation: Department of Surgery, Yokohama City University, School of Medicine, Japan. rino@med.yokohama-cu.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Akio
authors.initials: A
authors.lastname: Ashida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Harada
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kawamoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inagaki
authors.forename: Norio
authors.initials: N
authors.lastname: Yukawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Saeki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kanari
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yamada
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohshima
authors.forename: Roppei
authors.initials: R
authors.lastname: Yamada
authors.forename: Toshio
authors.initials: T
authors.lastname: Imada
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation; D005743:Gastrectomy / Q000379:methods*; D006488:Hemostasis, Surgical; D006801:Humans; D007813:Laparotomy; D008197:Lymph Node Excision / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D013274:Stomach Neoplasms / Q000601:surgery*