title: Transumbilical single-incision laparoscopic intracorporeal anastomosis for gastrojejunostomy: case report.
abstract: BACKGROUND
  Laparoscopic gastrojejunostomy allows effective palliation and rapid recovery for the patient with limited survival due to advanced pancreatic cancer presenting with gastric outlet obstruction. Transumbilical single-incision laparoscopic surgery (SILS) offers excellent cosmetic results and may be associated with decreased postoperative pain, reduced need for analgesia, and thus accelerated recovery. The authors report the first transumbilical single-incision laparoscopic intracorporeal anastomosis for gastrojejunostomy.
  
  
  METHODS
  Preliminary experience with transumbilical single-incision, intracorporeal anastomosis for gastrojejunostomy for a patient with gastric outlet obstruction caused by advanced pancreatic cancer is reported.
  
  
  RESULTS
  Transumbilical single-incision laparoscopic intracorporeal anastomosis for gastrojejunostomy was performed with a linear endoscopic stapler using an omega loop. The operative time was 117 min. No intra- or postoperative complications were recorded.
  
  
  CONCLUSIONS
  Transumbilical single-incision laparoscopic intracorporeal anastomoses are feasible using the endoscopic linear stapler. Transumbilical single-incision gastrojejunostomy for gastric outlet obstruction may improve cosmetic results and allow accelerated recovery for patients with limited survival. This anastomosis technique of single-incision laparoscopic surgery for other digestive tract procedures needs further evaluation.
authors.affiliation: Department of Surgery, University Hospital Geneva, Geneva, Switzerland. pascal.bucher@hcuge.ch
authors.forename: Pascal
authors.initials: P
authors.lastname: Bucher
authors.forename: François
authors.initials: F
authors.lastname: Pugin
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
mesh_terms: D005240:Feasibility Studies; D015390:Gastric Bypass / Q000379:methods*; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications*; D011788:Quality of Life; D014472:Umbilicus