title: Lymph Node Dissection Using Bipolar Vessel-Sealing Device During Reduced Port Laparoscopic Distal Gastrectomy for Gastric Cancer: Result of a Pilot Study from a Single Institute.
abstract: BACKGROUND
  The electrothermal bipolar vessel-sealing device (BVSD) is known to supply a strong vessel-sealing power. However, only few studies have reported lymph node dissection (LND) using only BVSD during laparoscopic surgery for gastric cancer. The purpose of this study was to investigate the feasibility of LND using BVSD during reduced port laparoscopic distal gastrectomy for gastric cancer.
  
  
  METHODS
  From May 2015, patients in whom three- or single-port laparoscopic distal gastrectomy had been engaged for gastric cancer were enrolled in this study. We performed D1+ or D2 LND using only LigaSure™Maryland (Medtronics, Minneapolis, MN), a recently developed BVSD. Clinical outcomes of these patients were investigated.
  
  
  RESULTS
  From May 2015 to November 2016, 20 patients were enrolled in this study. The mean operation time was 262.6 ± 36.6 (200-340) minutes. The mean time for LND was 124.7 ± 19.2 (93-171) minutes. Only one patient had a morbidity of Clavien-Dindo grade more than II. No mortality was observed in all patients. The mean number of retrieved lymph nodes was 46.8 ± 22.8 (15-105).
  
  
  CONCLUSIONS
  LND using the Maryland jaw type BVSD was feasible during reduced port (single- or three-port) laparoscopic distal gastrectomy for gastric cancer. Objectively evaluating the potential advantages of BVSD in reduced port laparoscopic surgery is necessary.
authors.affiliation: Department of Surgery, Korea University College of Medicine , Seoul, Korea.
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Lee
authors.affiliation: Department of Surgery, Korea University College of Medicine , Seoul, Korea.
authors.forename: Da Won
authors.initials: DW
authors.lastname: Park
authors.affiliation: Department of Surgery, Korea University College of Medicine , Seoul, Korea.
authors.forename: Sungsoo
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Surgery, Korea University College of Medicine , Seoul, Korea.
authors.forename: Jong-Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Korea University College of Medicine , Seoul, Korea.
authors.forename: Seong-Heum
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Surgery, Korea University College of Medicine , Seoul, Korea.
authors.forename: Chong-Suk
authors.initials: CS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010865:Pilot Projects; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: bipolar vessel-sealing device; reduced port laparoscopic surgery; stomach neoplasm