Needle device‐assisted single‐incision laparoscopic gastrectomy for early gastric cancer: A propensity score‐matched analysis

Abstract

Introduction Single‐incision laparoscopic gastrectomy can be difficult because of complex instrumentation and a limited working angle. We standardized a needle device‐assisted single‐incision laparoscopic gastrectomy (NA‐SILG) procedure for early gastric cancer in 2013. Herein, we present our technique and evaluate it in comparison to the conventional laparoscopic gastrectomy CLG) technique. Methods We retrospectively reviewed medical records of 149 patients who underwent a NA‐SILG or distal (CLG) for early gastric cancer between January 2013 and August 2016. We performed 1:1 propensity score matching between the two groups. Results Eighteen patients who underwent a NA‐SILG and 131 who underwent a CLG were included. Almost all patients were in clinical stage IA. Operative times were 216 ± 29.7 minutes and 220 ± 51.7 minutes for the NA‐SILG and CLG groups, respectively; the median intraoperative bleeding amounts were 5 mL and 10 mL for the NA‐SILG and CLG groups, respectively. The median number of retrieved lymph nodes was 41.5 and 57 for the NA‐SILG and CLG groups, respectively. The number of patients needing analgesics was significantly lower in the NA‐SILG group (P = .003) than in the CLG group. Neither group had postoperative complications more severe than Clavien‐Dindo classification III. Conclusion Needle device‐assisted SILG is safe and feasible for early gastric cancer treatment in slim figure patients. It has short and long‐term outcomes comparable to the CLG but is less invasive and results in less postoperative pain.

Postoperative pain and quality of life after single-incision distal gastrectomy versus multiport laparoscopic distal gastrectomy for early gastric cancer – a randomized controlled trial

“…Also, new surgical devices are being released in the market to make this procedure more feasible. Needlescopic devices can be used to assist the procedure similar to MLDG, but with barely other visible scars other than the main wound [ 26 ]. Nevertheless, since this study showed negative results, we believe that when the procedure becomes too difficult or risky or extremely stressful to the operator, there is no need to insist on performing SIDG instead of MLDG.…”