Laparoscopy-assisted distal gastrectomy with 3-cm laparotomy, left hepatic lobe compression technique, and selection of automatic anastomosis device.
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.
Rino
Yasushi
Y
Department of Surgery, Yokohama City University, School of Medicine, Japan. rino@med.yokohama-cu.ac.jp
Ashida
Akio
A
Harada
Hiroshi
H
Kawamoto
Masakazu
M
Inagaki
Daisuke
D
Yukawa
Norio
N
Saeki
Hiroyuki
H
Kanari
Masahiro
M
Yamada
Takanobu
T
Masuda
Munetaka
M
Ohshima
Takashi
T
Yamada
Roppei
R
Imada
Toshio
T
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*