Reduced port laparoscopic gastrectomy for gastric cancer

Inaki, Noriyuki; Tsuji, Toshikatsu; Doden, Kenta; Sakimura, Yusuke; Tawara, Hiroki; Matsui, Ryota; Yamamoto, Daisuke; Kitamura, Hirotaka; Bando, Hiroyuki; Yamada, Tetsuji

doi:10.21037/tgh.2016.04.04

Cited by 18 publications

(13 citation statements)

References 44 publications

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“…For EGC patients who are not eligible for endoscopic resection, laparoscopic surgery is widely performed and is recommended over open surgery according to the Korean Practice Guidelines for Gastric Cancer 2018 [ 4 ]. More recently, surgeons have started performing reduced-port laparoscopic surgery to treat gastric cancer, with several publications demonstrating the feasibility of reduced-port laparoscopic gastrectomy [ 5 6 7 8 9 ].…”

Section: Introductionmentioning

confidence: 99%

Is it Beneficial to Utilize an Articulating Instrument in Single-Port Laparoscopic Gastrectomy?

Kim

Lee

2021

J Gastric Cancer

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Purpose As the number of gastric cancer survivors is increasing and their quality of life after surgery is being emphasized, single-port surgery is emerging as an alternative to conventional gastrectomy. A novel multi-degree-of-freedom (DOF) articulating device, the ArtiSential ® device (LivsMed, Seongnam, Korea), was designed to allow more intuitive and meticulous control for surgeons facing ergonomic difficulties with conventional tools. In this study, we evaluated the feasibility of this new device during single-port laparoscopic distal gastrectomy (SP-LDG) for early gastric cancer (EGC) patients. Materials and Methods Consecutive patients diagnosed with EGC who underwent SP-LDG with ArtiSential ® (LivsMed) graspers between April 2018 and August 2020 were enrolled in the study. The clinical outcomes were compared with those of a control group, in which prebent graspers (Olympus Medical Systems Corp) were used for the same procedures. Results Seventeen patients were enrolled in the ArtiSential ® group. There was no significant difference in operative time (205.4±6.0 vs. 218.1±9.9 minutes, P= 0.270) or the quality of surgery, in terms of the number of retrieved lymph nodes (49.5±3.5 vs. 45.9±4.0, P=0.473), length of hospital stay (15.4±2.0 vs. 12.4±1.3 days, P=0.588), and postoperative complications (40.0% vs. 41.2%, P=0.595), between the ArtiSential ® group and the control group. Conclusions The new multi-DOF articulating grasper is feasible and can be used as an alternative for prebent graspers during SP-LDG.

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Section: Introductionmentioning

confidence: 99%

Is it Beneficial to Utilize an Articulating Instrument in Single-Port Laparoscopic Gastrectomy?

Kim

Lee

2021

J Gastric Cancer

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“…As laparoscopic surgery has gradually been accepted as a method of treating cancer, reducing the number of ports has become a trend to make the operation more minimally invasive and better cosmetic effects [ 1 – 3 ]. Even though ovarian tumors or cysts may grow very large, laparoscopy has been proven to be feasible for ovarian cyst larger than 10 cm [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of perioperative outcomes of single-port laparoscopy, three-port laparoscopy and conventional laparotomy in removing giant ovarian cysts larger than 15 cm

Wang

2021

BMC Surg

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Background Although conventional laparoscopy has gradually accepted as a surgical treatment for ovarian cancer, reducing the port numbers of laparoscopy still has great challenge for larger ovarian tumors. Thus, this study aims to explore the surgical outcomes of single-port laparoscopy for removing giant ovarian cysts (≥ 15 cm) and compare with laparotomy and three-port laparoscopy. Methods This study enrolled 95 patients with giant ovarian cysts (> 15 cm) who underwent single-port laparoscopy, three-port laparoscopy or laparotomy. Their medical records, perioperative surgical outcomes, and postoperative pain score and complications were analyzed and compared retrospectively. Results Single-port laparoscopy showed better perioperative outcomes and less postoperative pain than three-port laparoscopy and laparotomy. The time between post-surgery and getting out of bed in single-port laparoscopy was significant shorter than that in the laparotomy and three-port laparoscopy (17.53 ± 7.26 vs 29.40 ± 9.57 vs 24.56 ± 7.76, P < 0.01). The length of hospital stay in single-port laparoscopy was significantly shorter than that in other two groups (4.06 ± 0.5 vs 5.46 ± 1.63 vs 4.81 ± 0.83, P < 0.001). In addition, single-port laparoscopy had the lowest postoperative pain scores than in the laparotomy and three-port laparoscopy. There were no significant differences of total hospital cost, postoperative complications and time until gas passing among the three surgical groups. Importantly, in the removal of giant ovarian cysts, the proportion of cyst rupture in single-port laparoscopy was far lower than that in three-port laparoscopy (3.0 vs 22.2%). Conclusions For giant ovarian cysts, single-port laparoscopy is still a safe and efficient technique with the advantages of short operation time, less estimated blood loss, short hospital stay, lower spillage rate, and less postoperative pain.

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“…In conventional laparoscopic distal gastrectomy (CLDG), 5 ports are considered the standard. Accumulation of surgical experience and advances in surgical techniques have led to the development of reduced port laparoscopic distal gastrectomy (RPLDG), a less invasive alternative to CLDG [ 5 6 7 ]. Most studies have evaluated the performance of RPLDG by expert surgeons who have considerable experience with CLDG [ 8 9 10 11 12 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Reduced Port Laparoscopic Distal Gastrectomy Performed by a Novice Surgeon

2021

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Purpose Reduced port laparoscopic distal gastrectomy (RPLDG) using 3 ports is less invasive than conventional laparoscopic distal gastrectomy (CLDG) using 5 ports. Although RPLDG performed by expert surgeons is safe and feasible, novice surgeons have difficulty performing this procedure. This study evaluated the surgical outcomes and feasibility of RPLDG performed by a novice surgeon. Materials and Methods The records of 136 patients who underwent laparoscopic distal gastrectomy for gastric cancer performed by a single novice surgeon between May 2016 and December 2018 were retrospectively reviewed. Among these 136 patients, 52 underwent RPLDG and 84 underwent CLDG. The clinicopathological characteristics, operative outcomes, and short-term postoperative outcomes of the 2 groups were compared. Results The percentage of women was significantly higher in the RPLDG group than in the CLDG group (48.1% vs. 31%; P=0.045), but other baseline characteristics did not differ significantly between the groups. Billroth II anastomosis was performed significantly more frequent (90.4% vs. 73.8%, P=0.015) and operation time was significantly shorter (207.1±43.3 min vs. 225.5±44.6 min, P=0.020) in the RPLDG group than in the CLDG group. The time to first flatus, postoperative pain score, length of postoperative hospital stay, and incidence and severity of complications did not differ significantly between the groups. Analysis of the learning curve based on the operation time showed that performing RPLDG on 20–30 patients was required to achieve technical proficiency. Conclusions RPLDG is a safe and feasible surgical procedure for the treatment of gastric cancer, even when performed by a novice surgeon.

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Reduced port laparoscopic gastrectomy for gastric cancer

Cited by 18 publications

References 44 publications

Is it Beneficial to Utilize an Articulating Instrument in Single-Port Laparoscopic Gastrectomy?

Is it Beneficial to Utilize an Articulating Instrument in Single-Port Laparoscopic Gastrectomy?

Comparison of perioperative outcomes of single-port laparoscopy, three-port laparoscopy and conventional laparotomy in removing giant ovarian cysts larger than 15 cm

Evaluation of Reduced Port Laparoscopic Distal Gastrectomy Performed by a Novice Surgeon

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