TY - JOUR
T1 - Intracorporeal semi-hand-sewn Billroth I reconstruction in total laparoscopic distal gastrectomy
AU - Kikuchi, Satoru
AU - Kuroda, Shinji
AU - Nishizaki, Masahiko
AU - Kuwada, Kazuya
AU - Takata, Nobuo
AU - Kakiuchi, Yoshihiko
AU - Yano, Shuya
AU - Noma, Kazuhiro
AU - Kagawa, Shunsuke
AU - Fujiwara, Toshiyoshi
N1 - Publisher Copyright:
© 2020 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - INTRODUCTION: Intracorporeal Billroth I (B-I) reconstruction using an endoscopic linear stapler (ELS) is widely performed in total laparoscopic distal gastrectomy. However, conventional procedures require many ELSs for anastomosis. Here, we introduce the novel intracorporeal semi-hand-sewn (SHS) B-I reconstruction. MATERIALS AND SURGICAL TECHNIQUE: After the transection of stomach and duodenum using ELS following adequate lymph node dissection, small entry holes were made on the anterior wall in the greater curvature of the stomach and the duodenal stump. The posterior walls of both the remnant stomach and the duodenum were attached with the ELS and fired to create the posterior wall of the B-I anastomosis. All the transection line of the duodenum and one-third of the transection line of the stomach were dissected; finally the anterior wall suturing at the anastomotic site was performed by the laparoscopic hand-sewn technique. DISCUSSION: SHS procedure was performed for 17 gastric cancer patients. There were no intraoperative complications or conversions to open surgery. One intra-abdominal abscess was observed although there was no anastomotic leakage. The median reconstruction time was 48 minutes (32-63). The SHS procedure was safe, feasible, and economical, although it requires sufficient laparoscopic suturing and ligation skill.
AB - INTRODUCTION: Intracorporeal Billroth I (B-I) reconstruction using an endoscopic linear stapler (ELS) is widely performed in total laparoscopic distal gastrectomy. However, conventional procedures require many ELSs for anastomosis. Here, we introduce the novel intracorporeal semi-hand-sewn (SHS) B-I reconstruction. MATERIALS AND SURGICAL TECHNIQUE: After the transection of stomach and duodenum using ELS following adequate lymph node dissection, small entry holes were made on the anterior wall in the greater curvature of the stomach and the duodenal stump. The posterior walls of both the remnant stomach and the duodenum were attached with the ELS and fired to create the posterior wall of the B-I anastomosis. All the transection line of the duodenum and one-third of the transection line of the stomach were dissected; finally the anterior wall suturing at the anastomotic site was performed by the laparoscopic hand-sewn technique. DISCUSSION: SHS procedure was performed for 17 gastric cancer patients. There were no intraoperative complications or conversions to open surgery. One intra-abdominal abscess was observed although there was no anastomotic leakage. The median reconstruction time was 48 minutes (32-63). The SHS procedure was safe, feasible, and economical, although it requires sufficient laparoscopic suturing and ligation skill.
KW - Billroth I reconstruction
KW - gastric cancer
KW - laparoscopic distal gastrectomy
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U2 - 10.1111/ases.12887
DO - 10.1111/ases.12887
M3 - Article
C2 - 33111451
AN - SCOPUS:85111790253
VL - 14
SP - 640
EP - 643
JO - Asian journal of endoscopic surgery
JF - Asian journal of endoscopic surgery
SN - 1758-5902
IS - 3
ER -