Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic–assisted gastrectomy

Hyung, Woo Jin; Lim, Joon Seok; Cheong, Jae Ho; Kim, Joo Hang; Choi, Seung Ho; Song, Si Young; Noh, Sung Hoon

doi:10.1007/s00464-004-8196-3

Cited by 90 publications

(92 citation statements)

References 19 publications

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“…A limitation of a completely laparoscopic technique is the difficulty of locating the tumor intraoperatively. Hyung et al [12] reported that the resection line could be defined based on a combination of preoperative endoscopic clipping and intraoperative laparoscopic ultrasonography. Tanimura et al [13] employed preoperative endoscopic inking.…”

Section: Discussionmentioning

confidence: 99%

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

et al. 2011

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Background We developed a new method of intracorporeal gastroduodenostomy, the delta-shaped anastomosis, in which only endoscopic linear staplers are used. In this report, we present the short-and long-term outcomes of our initial experience with this procedure. Methods We retrospectively analyzed 100 consecutive gastric cancer patients who underwent the delta-shaped anastomosis procedure from May 2001 to November 2006. All of them underwent a laparoscopic distal gastrectomy with regional lymph node dissection. Quality of life was assessed with a questionnaire 6 months or more postoperatively, and the gastric remnant was evaluated by endoscopy one year following the surgery. Results Eight surgeons successfully performed the deltashaped anastomosis without any conversion to laparotomy. The learning curve for all surgeons was steep and the mean time for the anastomosis was 13 min. Only one patient developed an anastomotic leak, and the leak was minor. Sixty-five patients tolerated a 1500 kcal/day soft diet at the time of discharge. The mean follow-up period was 54.9 months. Only one patient reported symptoms indicative of dumping. Two patients were diagnosed with reflux esophagitis, and approximately 70% had evidence of bile reflux, but severe gastritis of the remnant stomach on endoscopy was uncommon. Conclusions The wide lumen of the delta-shaped anastomosis led to early, adequate postoperative oral intake without a significant incidence of dumping syndrome. The delta-shaped anastomosis is safe and simple and provides satisfactory postoperative results.

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Section: Discussionmentioning

confidence: 99%

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

et al. 2011

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“…So far, in the clinical setting, several techniques for intraoperative identification of the tumor have been reported, such as preoperative or intraoperative tattooing [8,14], intraoperative endoscopy [15], intraoperative radiography [9,16], and intraoperative ultrasonography [7]. Preoperative tattooing with dye injection is probably the simplest of these, and is often used in colon surgery [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the establishment of an intraoperative tumor localization technique during TLG remains an important issue. Although several methods have been reported to date [7][8][9][10], none are considered consistently reliable.…”

Section: Introductionmentioning

confidence: 99%

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Simple and reliable method for tumor localization during totally laparoscopic gastrectomy: intraoperative laparoscopic ultrasonography combined with tattooing

et al. 2016

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We have developed a new method to localize a tumor during totally laparoscopic gastrectomy that uses intraoperative laparoscopic ultrasonography combined with preoperative clipping and tattooing. One or 2 days before the surgery, endoscopic clipping was performed just proximal to the tumor, followed by tattooing with India ink at the clipping site. Examination by intraoperative laparoscopic ultrasonography was performed at the tattooed site to detect the clips. The resection line of the stomach was determined with use of the detected clips as a marker of the proximal margin of the tumor. This method was attempted in 14 patients who underwent totally laparoscopic gastrectomy, and the clips were successfully identified in all patients. The clips were visualized as several layers of a hyperechoic bar, which was termed a ''ladder sign.'' The mean time from insertion of the laparoscopic probe to identification of the clips was 2 min. The ladder sign is an important finding in this method.

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“…To determine the proximal resection line for R0 resection, preoperative endoscopic placement of radiopaque hemoclips or intraoperative endoscopic localization is required, especially for small or non‐palpable tumors 12, 13, 14, 15. Regarding the extent of lymph node dissection, it follows the Japanese classification of Gastric Carcinoma guidelines: D1+ lymph node dissection is indicated for clinically early gastric cancer without evidence of lymph node metastasis and D2 is indicated for advanced gastric cancer or any evidence of regional lymph node involvement 10…”

Section: Indications Of Robotic Applicationmentioning

confidence: 99%

Robotic gastrectomy for gastric cancer: Current evidence

Alhossaini

Altamran

Seo

et al. 2017

Annals of Gastroent Surgery

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The robotic system has gained wide acceptance in specialties such as urological and gynecological surgery. It has also been applied in the field of upper gastrointestinal surgery. Since the first implementation of the robotic system for the treatment of gastric adenocarcinoma, the procedure has been found to be safe and feasible. Although robotic gastrectomy does not meet our expectations and yield better results than laparoscopic gastrectomy, this procedure seems to provide several advantages over laparoscopy such as reduced blood loss, shorter learning curves and increased number of retrieved lymph nodes. However, as many case series, including a recent multicenter study, have revealed, higher cost and longer operation time are the major limitations of robotic gastrectomy. Furthermore, there are no results from well‐designed randomized clinical trials comparing the two procedures. New procedures in much more technically demanding cases will test the genuine benefits of robotic gastrectomy.

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Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic–assisted gastrectomy

Abstract: Using LUS to detect endoscopic clips is an easy, safe, and accurate method to localize EGC lesions in laparoscopic-assisted gastrectomy.

Cited by 90 publications

References 19 publications

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

Simple and reliable method for tumor localization during totally laparoscopic gastrectomy: intraoperative laparoscopic ultrasonography combined with tattooing

Robotic gastrectomy for gastric cancer: Current evidence

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