title: Gasless laparoscopic distal gastrectomy with Roux-en-Y reconstruction.
abstract: OBJECTIVE
  Laparoscopic-assisted distal gastrectomy (LADG) is a minimally invasive procedure for patients with gastric carcinoma. We have previously reported gasless LADG with a Billroth-I reconstruction using a 5-7cm minilaparotomy. We modified the technique for gasless LADG to include a Roux-en Y reconstruction and to expand the indications for its use.
  
  
  METHODS
  A total of 40 patients with early stage gastric tumors (T1 n=38, T2 n=2) underwent this procedure. Following gasless laparoscopic distal gastrectomy with lymph node dissection, a jejunum to greater curvature of the gastric remnant anastomosis was performed using an intracorporeal laparoscopic stapled method. The jejuno-jejunal anastomosis was performed using a hand-sewn technique under direct vision through a mini-laparotomy.
  
  
  RESULTS
  The mean surgical time (n=40) was 222 min, estimated blood loss 101 ml, and the mean number of lymph nodes harvested was 21. There were no postoperative complications such as bleeding, leak, or cardio-pulmonary dysfunction. Mean body weight loss was 3.9 kg, and there is no evidence of recurrence during a mean followup of 14 months.
  
  
  CONCLUSIONS
  Gasless LADG with Roux-en-Y reconstruction is a feasible, novel procedure for a minimally invasive approach to gastric cancer.
authors: Department of Surgery, Jichi Medical University, Tochigi, Japan. hosoyo@jichi.ac.jp
authors: Yoshinori
authors: Y
authors: Hosoya
authors: Alan
authors: A
authors: Lefor
authors: Masanobu
authors: M
authors: Hyodo
authors: Toru
authors: T
authors: Zuiki
authors: Hidenori
authors: H
authors: Haruta
authors: Kentaro
authors: K
authors: Kurashina
authors: Shin
authors: S
authors: Saito
authors: Yoshikazu
authors: Y
authors: Yasuda
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged