title: Techniques of the Single-Port Totally Laparoscopic Distal Gastrectomy.
abstract: BACKGROUND
  Single-port laparoscopic surgery for patients with early gastric cancer has been rarely reported. Our aim was to introduce techniques of the single-port totally laparoscopic distal gastrectomy (TLDG) in patients with early gastric cancer.
  
  
  METHODS
  This procedure was performed using only one 3-3.5 cm skin incision on the umbilicus. One 12 mm and two 10 mm ports were used, and the flexible scope was used during the operation. Partial omentectomy with D1 + β or more lymph node dissection was performed. Bowel continuity was restored by intracorporeal gastroduodenostomy using two linear staplers.
  
  
  RESULTS
  A total of 30 patients underwent single-port TLDG from June to August 2014. Median age of patients was 55 years (range 33-77) and median body mass index of patients was 21.2 kg/m(2) (range 15.7-26.1). Sixteen of 30 patients (53.3 %) were female. Operating times were 122.6 min, and blood losses during operations were 103.2 ml on average. The median length of postoperative hospital stay was 7 days, and the median number of dissected lymph nodes was 40 (range 16-67). No patients had dissected lymph nodes <15. The rate of complications was 20 % (6/30 patients), and no patients had an incisional hernia. Two patients experienced ileus (6.7 %), another two patients experienced delayed gastric emptying (6.7 %), and one patient suffered from small bowel obstruction. There were no postoperative mortalities.
  
  
  CONCLUSIONS
  The single-port TLDG for patients with early gastric cancer is feasible in very selected patients and in specialized gastric cancer centers with experience in multi-trocar laparoscopy and single-port laparoscopic surgery.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Su Mi
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Man Ho
authors.initials: MH
authors.lastname: Ha
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Seo
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Min Gew
authors.initials: MG
authors.lastname: Choi
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Sohn
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Bae
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sung
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. gsjunholee@gmail.com.
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000601:surgery*