A secure technique of intracorporeal Roux-Y reconstruction after laparoscopic distal gastrectomy - 18/08/11
, Eiji Nomura, M.D. a, Hideaki Mabuchi, M.D. a, San-Woong Lee, M.D. a, Tomoyuki Agui, M.D. a, Yoshiharu Miyamoto, M.D. a, Mitsuhiko Iwamoto, M.D. a, Hisashi Watanabe, M.D. a, Nobuhiko Tanigawa, M.D. a : F.A.C.S.Abstract |
Background |
Laparoscopic distal gastrectomy [LDG] is a minimally invasive surgery for gastric carcinoma. The Billroth I method has been commonly employed to reconstruct alimentary tract after LDG. Conversely, Roux-Y reconstruction is employed far less commonly despite its merits. Technical difficulties, including a risk of twisting the Roux loop under limited vision through a laparoscope, have hampered Roux-Y reconstruction after LDG.
Methods |
We performed LDG and intracorporeal Roux-Y reconstruction in 5 patients with early gastric cancer. The procedure included a functional end-to-end anastmosis of the stomach and jejunum, consisting of side-to-side approximation of jejunal loop to greater curvature of the gastric remnant with a laparoscopic stapling device followed by closure of the open end and simultaneous division of the jejunum with another stapler.
Results |
Roux-Y reconstruction was successfully accomplished without torsion of the loop in all patients.
Conclusions |
By using the present technique, intracorporeal Roux-Y reconstruction after LDG can be accomplished without a risk of twisting the jejunal loop.
Le texte complet de cet article est disponible en PDF.Keywords : Laparoscopy, Gastric cancer, Roux-Y reconstruction, Intracorporeal anastomosis
Plan
Vol 189 - N° 2
P. 178-183 - février 2005 Retour au numéro
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