Reduced port surgery for laparoscopic distal gastrectomy? Report of the initial cases

Atsushi Iida, MD, Daisuke Fujimoto, MD, Yasuo Hirono, MD, Takanori Goi, MD, Kanji Katayama, MD, Akio Yamaguchi, MD

Department of Gastroenterological Surgery, Center of Cancer Treatment*, University of Fukui, Japan

[Background]
We indicated the totally laparoscopic distal gastrectomy (TLDG) for the cases of gastric cancer patients who were diagnosed as T1N0M0 or T2N0M0 pre-operatively.

[Aim]
We report our initial cases of reduced port surgery (RPS) for TLDG.

[Operative procedure]
The symmetrical setting by each two of 12mm and 5mm trocars was applied for our 34 cases of totally laparoscopic distal gastrectomy with lymphadenectomy. In recent two cases, we reduce the 12mm and 5mm port at the left side for the assistant surgeon, by using EndoGrab system (EG).

[Results]
The operative time was 287-395 min, the bleeding was 10-100g in RPS, and 293-484 min, 0-300g in ordinal TLDG. The post operative course was uneventful as same as ordinally TLDG. The patients started liquid intake from the next day of the surgery, and discharged within 14 post-operative days.

[Discussion]
EG enable to make the feasible operative field as ordinal TLDG, while RPS contains a risk to fail on reproducing the field. It might have the benefit to control the operative field by surgeon, not by assistant surgeon, beyond the less invasiveness for the damage of the abdominal wall. The problem of EG was the invariable distance between the target point and abdominal wall. It will be solved by the evolution of the instrument.

[Conclusion]
RPS of TLDG was safely performed by using EG. The procedure will be innovated by the evolution of the instrument for the patient’s benefit.


Session: Poster Presentation

Program Number: P217

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