Huang's three-step maneuver for laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer.
Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding at the splenic hilum,the procedure remains challenging and technically demanding procedure for the performance of laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection. Based on our experiences, we gradually explored a set of procedural operation steps called "Huang's three-step maneuver". In this paper, we not only provide the concrete operation steps for the surgeon, but we also provide our recommended technique of pulling and exposure for assistants. This new maneuver simplifies the complicated procedure and improves the efficiency of laparoscopic spleen-preserving splenic hilar lymphadenectomy, making it easier to master and allowing for its widespread adoption.
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Chang-Ming
CM
Huang
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Qi-Yue
QY
Chen
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Jian-Xian
JX
Lin
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Chao-Hui
CH
Zheng
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Ping
P
Li
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Jian-Wei
JW
Xie
Stomach neoplasms; laparoscopy; lymph node dissection; spleen preservation