• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Laparoscopic assisted distal gastrectomy with Billroth I reconstruction by using circular stapler

Nobuhiro Takiguchi, MD, PhD, Yoshihiro Nabeya, MD, PhD, Atsushi Ikeda, MD, PhD, Hiroaki Soda, MD, PhD, Toru Tonooka, MD, PhD, Isamu Hoshino, Toshiya Sakamoto, MD, Yousuke Iwadate, MD. Chiba Cancer Center

Objectives: Laparoscopic distal gastrectomy for early gastric cancer is a standard treatment in Japan described in guidelines. The surgical procedure has been shifting from laparoscopic assisted to complete laparoscopic surgery. In this study, we evaluated the outcomes and safety of the laparoscopic assisted distal gastrectomy.

Methods: For the marking of the oral side transecting line, the clipping at oral side of cancer lesion was performed by gastro-endoscopy before surgery. The lymph node dissection (D1 + / D2) is performed laparoscopically. As the dissection of the pancreatic superior region, the assistant hold the left gastric artery and keep the good view by retracting the pancreas. The common hepatic artery and proximal side of splenic artery are exposed. Both sides of the left gastric artery and vein are exposed. Left gastric vein and left gastric artery are cut after clipping and sealing. Lymph node dissention of hepato-duodenal ligament is done and right gastric artery is cut after clipping and sealing. Minor curvature of upper gastric wall is exposed (No1,3 dissection). Billroth I reconstruction by the Circular Stapler (CDH) is performed. Through the upper median incision with 5 cm, operator pulls out the stomach and transects the oral side of stomach with linear stapler after palpating the clips. Duodenum is transected after purse string suture. Gastroduodenal anastomosis is performed by CDH.

Results: Two hundred cases were analyzed. The operation time, blood loss and the conversion to open surgery rate were 175 minutes, 40 ml, and 1.0%, respectively. As postoperative complications, anastomotic failure, pancreatic fistula and postoperative bleeding were 2%, 1.5% and 1%, respectively. The reoperation rate was 2%. One surgical death due to cerebral infarction was experienced. There were no patients with pPM (pathological proximal margin) positive and too much PM distance. Frequency of abdominal wall incisional hernia and ileus were 1% and 0%, respectively.

Conclusion: Although there is the disadvantage that small laparotomy can be made in the upper abdomen, laparoscopic assisted distal gastrectomy with Billroth I reconstruction in our procedure is enough good from the viewpoint of the precision of proximal margin, and the incidence of serious complications.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86405

Program Number: P693

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

69

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons