• 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 Total Gastrectomy for Gastric Cancer Patients

TATSUSHI SUWA, MD PhD, KAZUHIRO KARIKOME, MD, NAOKI ASAKAGE, MD PhD, EISHI TOTSUKA, MD PhD, NAOKAZU NAKAMURA, MD PhD, KEIGO OKADA, MD, TOMONORI MATSUMURA, MD. Kashiwa Kousei General Hospital

INTRODUCTION

Laparoscopic total gastrectomy (LTG) has not become as popular as laparoscopic distal gastrectomy because of the more difficult reconstruction technique. To reduce the technical difficulties, we have made some modifications to the procedure. Our procedure is shown as follows:

SURGICAL PROCEDURE

1. A 5-cm incision was made in the upper midline and omentectomy is initiated through this small incision using a mini-retractor (Kent Retractor TKZ-F10328-D5; Takasago Medical Industry Co Ltd., Tokyo, Japan). A 12-mm trochar was inserted below the navel for a laparoscope. A 5-mm trochar was inserted in the upper right abdomen for a snake retractor to pull up lateral segment of liver, and a snake retractor’s holder was used for this trochar site. A 12-mm trochar was inserted in the upper left abdomen for operator’s right hand. An abdominal wall sealing device (Lap Disk®) was used for a 5-cm incision and a 12-mm trochar was placed through Lap Disk for operator’s left hand.
2. Under laparoscopic view, dissection for lymph nodes along the right gastroepiploic vessels and left gastroepiploic vessels were made, the suprapyloric and inflapyloric lymph nodes were dissected. The duodenum was cut with a linear stapler.
3. The lesser omentum was cut. The left gastric vein and artery was divided after double-clipping safely under a very nice surgical view by pulling up the stomach to the anterior abdominal wall. The dissection of the lymph node along the left gastric artery was made. The short gastric vessels were cut and full mobilization of the abdominal esophagus was made for easier handling of the esophagus.
4. Through a 5-cm minilaparotomy, transection of the esophagus was performed with purse-string suture (using Purstring®). This part was easily performed by pulling up the stomach through minilaparotomy and pulling abdominal wall by Kent mini-retractor. The 25-mm anvil is inserted into the esophagus.
5. After jejunojejunostomy is performed through a minilaparotomy, preparing a 40-cm Roux-en-Y jejunal limb, a circular stapler is inserted into the jejunum and the esophagojejunostomy was made. The jejunal stump is closed with a linear stapler.

RESULTS

We have performed LTG with Roux-en-Y reconstruction without any anastomotic complications in recent years. We believe our procedure is secure and reliable for patients with early gastric cancer like the conventional open procedure.


Session: Poster
Program Number: P256
View Poster

322

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