Laparoscopy-assisted distal gastrectomy with intracorporeal Billroth I stapled anastomosis using a hand access device for patients with gastric cancer.
BACKGROUND
Billroth I gastroduodenostomy is an anastomotic procedure used widely after gastric resection for distal gastric cancer. As laparoscopy-assisted distal gastrectomy (LADG) gains increasing popularity, various techniques of laparoscopic gastroduodenal anastomosis are being introduced.


METHODS
To investigate the feasibility and benefit of their novel surgical technique of intracorporeal Billroth I stapled anastomosis using a hand access device (IBISA-HAD), the authors performed LADG using IBISA-HAD for 23 patients with distal gastric cancer and LADG using minilaparotomy Billroth I stapled anastomosis (MLBISA) for 10 patients.


RESULTS
The time required for the anastomosis procedure of IBISA-HAD was 45.5 +/- 12.0 min, and the operative time, perioperative transfusion, and hospital stay were not significantly different between IBISA-HAD and MLBISA. The IBISA-HAD procedure provided a markedly enhanced vision of the stapling process, leading to less wound retraction and extension than MLBISA.


CONCLUSIONS
The IBISA-HAD technique can provide a markedly enhanced view of the stapling procedure with the help of a current state-of-art laparoscopy system. The authors believe that this novel technique can guide an accurate laparoscopic anastomosis for the surgeon dealing with obese patients who have distal gastric cancer.
Joo
Y-T
YT
Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University, Gyeongsang National University Hospital, 90 Chilam-dong, Jinju, Gyeongsangnam-do, South Korea.
Moon
H-G
HG
Lee
S H
SH
Jeong
C-Y
CY
Jung
E-J
EJ
Hong
S-C
SC
Choi
S-K
SK
Ha
W-S
WS
Park
S-T
ST
Lee
Y-J
YJ
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation*; D005763:Gastroenterostomy / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D017792:Surgical Stapling