Intracorporeal Esophagojejunostomy Using a Circular Stapler with a New Purse-String Suture Technique During Laparoscopic Total Gastrectomy

Kim, Wook; Cho, In; Jang, Dong Su; Hyung, Woo Jin

doi:10.1016/j.jamcollsurg.2012.10.008

Cited by 28 publications

(24 citation statements)

References 10 publications

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“…Various end-to-side anastomosis techniques have also been consistently reported [17][18][19] . The key to this anastomosis is performing the purse-string suture and inserting the anvil into a fragile/contracted esophagus.…”

Section: Discussionmentioning

confidence: 99%

Intracorporeal esophagojejunostomy using the double stapling technique after laparoscopic total gastrectomy: A retrospective case-series study

Kim

Choi

Kim

et al. 2015

WJG

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AIM:To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy (LTG). METHODS:Between July 2010 and December 2012, 58 consecutive patients with early gastric cancer underwent LTG were enrolled. We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients. Then patients' characteristics, perioperative outcome and histopathologic data were analyzed retrospectively. RESULTS:The mean age and body mass index were 59.3 ± 9.7 years and 22.7 ± 2.6 kg/m 2 . The mean operation, reconstruction and anvil insertion times (from gastric incision to linear stapling) were 251.8 ± 57.0, 43.1 ± 2.8 and 4.2 ± 1.9 min, respectively. Intraoperative blood loss was 204.6 ± 156.3 mL and there was no open conversion. The postoperative complications were in 8 cases (delayed gastric emptying in 4 cases, pulmonary complication in 2 cases, pancreatitis in 1 case, anastomotic stricture in 1 case). Anastomotic stricture occurred after discharge and was recovered by endoscopic intervention. The patients were discharged at a mean of 9.6 ± 2.0 d after surgery. Neither leakage nor bleeding from the esophagojejunostomy occurred postoperatively. The mean proximal margin of specimen was 2.7 ± 2.8 cm CONCLUSION: Roux-en Y esophagojejunostomy using

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Section: Discussionmentioning

confidence: 99%

Intracorporeal esophagojejunostomy using the double stapling technique after laparoscopic total gastrectomy: A retrospective case-series study

Kim

Choi

Kim

et al. 2015

WJG

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“…(2, 3) However, anastomosis with a circular stapler is troublesome and requires special equipment for purse-string suture and anvil insertion. (4)(5)(6)(7)(8)(9) Likewise, anastomosis methods using linear staplers require advanced techniques and numerous staplers. (10)(11)(12)(13) We recently developed a new intracorporeal esophagojejunostomy method using linear staplers as an alternative to the existing methods.…”

Section: Introductionmentioning

confidence: 99%

Novel Intracorporeal Esophagojejunostomy Using Linear Staplers During Laparoscopic Total Gastrectomy: π-Shaped Esophagojejunostomy, 3-in-1 Technique

Kwon

Son

Ryu

2016

Journal of the American College of Surgeons

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“…However, laparoscopy-assisted or laparoscopic esophagojejunostomy cannot be performed in the same way as open esophagojejunostomy. A variety of techniques have been used for anvil insertion for a circular stapled esophagojejunostomy: laparoscopic hand-sewn purse-string sutures followed by intracorporeal insertion of the anvil [29,30], a novel purse-string instrument [Endo-PSI(II)] [31], insertion of an anvil through a small incision in the abdominal esophagus before dissection of the stomach and before the central rod is pulled out through the proximal esophagus followed by transection of the esophagus with a linear stapler [32], and an orally inserted anvil (OrVil TM ) system. The OrVil TM tube with its connection to the anvil head is introduced transorally and is extracted intracorporeally from the esophageal stump, and finally the central rod is removed from the connection tube [33,34].…”

Section: Reconstruction Methods After Laparoscopic Total Gastrectomymentioning

confidence: 99%

A systematic review of laparoscopic total gastrectomy for gastric cancer

et al. 2015

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Background Laparoscopic total gastrectomy (LTG) has been performed since 1999. Although surgical outcomes have been reported from Japan, Korea, China, and many Western countries, the effectiveness of this technique has not been conclusively established. This study therefore aimed to review the literature systematically. Methods Our search of the research literature identified 150 studies, which were mostly retrospective and from single institutions. Results There has recently been a remarkable increase in the number of studies from Korea, and the number of patients included in studies has increased since 2009. In most studies, the surgical procedures were longer, blood loss was reduced, and the number of retrieved lymph nodes was the same in the LTG group as in the open total gastrectomy group. The incidence of postoperative complications and that of inflammation during postoperative recovery were the same in these two groups. Conclusions During LTG, the method used for esophagojejunostomy is important for surgical reliability and to reduce postoperative complications. There has been rapid development of new techniques from the level of esophagojejunostomy through a small skin incision to the high level of intracorporeal esophagojejunostomy using various techniques. A nationwide prospective phase II study is urgently needed to establish the value of LTG.

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Intracorporeal Esophagojejunostomy Using a Circular Stapler with a New Purse-String Suture Technique During Laparoscopic Total Gastrectomy

Cited by 28 publications

References 10 publications

Intracorporeal esophagojejunostomy using the double stapling technique after laparoscopic total gastrectomy: A retrospective case-series study

Intracorporeal esophagojejunostomy using the double stapling technique after laparoscopic total gastrectomy: A retrospective case-series study

Novel Intracorporeal Esophagojejunostomy Using Linear Staplers During Laparoscopic Total Gastrectomy: π-Shaped Esophagojejunostomy, 3-in-1 Technique

A systematic review of laparoscopic total gastrectomy for gastric cancer

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