title: [Clinical application of reverse puncture device(RPD) in laparascopic esophagogastrectomy (esophagojejunostomy): a report of 18 cases].
abstract: OBJECTIVE
  The authors report the newly developed reconstruction technique after laparoscopic total gastrectomy (LTG) or laparoscopic distal gastrectomy (LDG): intracorporeal circular stapling esophagojejunostomy(esophagojejunostomy) using the reverse puncture device(RPD).
  
  
  METHODS
  After LTG or LDG, The anvil is then transorally inserted into the esophagus by using the RPD system. Double-stapling esophagojejunostomy with a circular stapler is performed intracorporeally, and the jejunal stump is closed with an Echelon.
  
  
  RESULTS
  There was no intraoperative complication or conversion to open surgery, the mean operation time was 155 min and blood loss was 75 ml. Postoperative fluorography revealed no anastomosis leakage or stenosis Patients resumed an oral liquid diet on postoperative day 2, and discharged at day 8.
  
  
  CONCLUSIONS
  We have successfully performed LTG or LDG, reconstruction using our technique in 18 patients without any anastomosis complications. We believe that our procedure is a safe and reliable reconstruction method, which is especially useful in obese patients, in whom conventional extracorporeal anastomosis is often difficult.
authors.affiliation: Minimally Invasive Surgery Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. archer771125@gmail.com.
authors.forename: Dan-lei
authors.initials: DL
authors.lastname: Chen
authors.forename: Dan
authors.initials: D
authors.lastname: Ding
authors.forename: Zhong-wei
authors.initials: ZW
authors.lastname: Ke
mesh_terms: D000714:Anastomosis, Surgical; D057868:Anastomotic Leak; D016629:Esophagectomy; D004944:Esophagoplasty; D004947:Esophagus / Q000601:surgery*; D005743:Gastrectomy; D006801:Humans; D007582:Jejunostomy; D007583:Jejunum; D010535:Laparoscopy / Q000295:instrumentation*; D061646:Operative Time; D011677:Punctures; D019651:Plastic Surgery Procedures; D013270:Stomach / Q000601:surgery*; D013274:Stomach Neoplasms; D017792:Surgical Stapling