Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy.
BACKGROUND
Laparoscopy-assisted total gastrectomy (LATG) is not a commonly performed procedure due to the surgical difficulty associated with reconstruction. Although various reconstruction methods have been reported, a standard technique has not yet been established. In this study, we compared the short-term outcomes of LATG reconstructed by mini-laparotomy and by the newly developed transorally inserted anvil (OrVil).


METHODS
From April 2006, a series of 45 patients underwent LATG. Of these, 15 were reconstructed by mini-laparotomy and 30 by OrVil. Short-term outcomes were compared between the two groups.


RESULTS
Operation time was significantly shortened and intraoperative blood loss significantly reduced by the use of OrVil. The postoperative course, including morbidity, did not differ between the two groups.


CONCLUSIONS
LATG using OrVil for the treatment of early gastric cancer is a technically feasible surgical procedure with sufficient lymph node dissection, satisfactory early recovery, and acceptable morbidity. It will be necessary to perform this novel technique in a large number of patients to confirm its feasibility.
Kunisaki
Chikara
C
Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57, Urafunecho, Minami-ku, Yokohama 232-0024, Japan. s0714@med.yokohama-cu.ac.jp
Makino
Hirochika
H
Oshima
Takashi
T
Fujii
Shoichi
S
Kimura
Jun
J
Takagawa
Ryo
R
Kosaka
Takashi
T
Akiyama
Hirotoshi
H
Morita
Satoshi
S
Endo
Itaru
I
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000295:instrumentation*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004867:Equipment Design; D004947:Esophagus / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D007583:Jejunum / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009055:Mouth; D011183:Postoperative Complications / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000601:surgery*; D017792:Surgical Stapling / Q000295:instrumentation*; D016896:Treatment Outcome