title: Reconstruction of the gastrointestinal tract by hemi-double stapling method for the esophagus and jejunum using EEA OrVil in laparoscopic total gastrectomy and proximal gastrectomy.
abstract: We report the method of anastomosis based on a hemi-double stapling technique (hereinafter, HDST) using a trans-oral anvil delivery system (EEA OrVil) for reconstructing the esophagus and lifted jejunum following laparoscopic total gastrectomy or proximal gastric resection. As a basic technique, end-to-side anastomosis was used for the cut-off stump of the esophagus and lifted jejunum. After the gastric lymph node dissection, the esophagus was cut off obliquely to the long axis using an automated stapler. EEA OrVil was orally, and a small hole was created at the tip of the obliquely cut-off stump with scissors to let the valve tip pass through. When it was confirmed that the automated stapler and center rod were made completely linear, the anvil and the main unit were connected with each other and firing was carried out. Then, HDST-based anastomosis was completed. The method may safe laparoscopic anastomosis between the esophagus and reconstructed intestine.
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan. norinori_hirahara@yahoo.co.jp
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hirahara
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Tanaka
authors.forename: Seiji
authors.initials: S
authors.lastname: Yano
authors.forename: Akira
authors.initials: A
authors.lastname: Yamanoi
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Minari
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Kawabata
authors.forename: Shuhei
authors.initials: S
authors.lastname: Ueda
authors.forename: Eiji
authors.initials: E
authors.lastname: Hira
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Hyakudomi
authors.forename: Toko
authors.initials: T
authors.lastname: Inao
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D004947:Esophagus / Q000601:surgery*; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008198:Lymph Nodes / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery; D017792:Surgical Stapling / Q000295:instrumentation / Q000379:methods*