title: [Totally laparoscopic Billroth II( gastrectomy without intracorporeal hand-sewn sutures].
abstract: OBJECTIVE
  To evaluate the safety and feasibility of a novel totally laparoscopic Billroth II gastrectomy.
  
  
  METHODS
  Twelve gastric cancer patients underwent totally laparoscopic D2 dissection without intracorporeal hand-sewn sutures in the Xijing Hospital of Fourth Military Medical University between May 2011 and July 2011. In this technique, circular stapling device was used for gastrojejunostomy, and an Endo GIA was used to close the incision at the greater curvature of the stomach. After the completion of the anastomosis, a side-to-side anastomosis (jejunum-afferent loop or jejunum-efferent loop) was performed using an Endo-GIA.
  
  
  RESULTS
  No patients required conversion to laparoscopy-assisted or open surgery. The operative time was 196.0±19.3 min, and the blood loss was 169.5±28.8 ml. The number of lymph node harvested was 25.1±3.3. The proximal resection margin and distal resection margin were 8.8±2.4 cm and 6.9±5.5 cm, respectively. The mean time to the first postoperative flatus was 3.1±1.3 days. The length of hospital stay was 4.5±1.9 days.
  
  
  CONCLUSIONS
  This technique is simple and quick. There is no need for laparoscopic hand-sewn suturing. It is safe to perform for totally laparoscopic gastrectomy and reconstruction.
authors.affiliation: Department of Surgery, Fourth Military Medical University, Xi'an 710032, China. dujjp@hotmail.com
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: DU
authors.forename: Jian-bo
authors.initials: JB
authors.lastname: Shuang
authors.forename: Jian-yong
authors.initials: JY
authors.lastname: Zheng
authors.forename: Ji-peng
authors.initials: JP
authors.lastname: Li
authors.forename: Qing-chuan
authors.initials: QC
authors.lastname: Zhao
authors.forename: Liu
authors.initials: L
authors.lastname: Hong
authors.forename: Jin
authors.initials: J
authors.lastname: Hua
authors.forename: Cheng
authors.initials: C
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D013537:Sutures