single port access total gastrectomy for gastric cancer

Shuji Kitashiro, PhD, Shunnichi Okushib, PhD, Tetuyuki Ookubo, PhD, Yo Kawarada, PhD, Masaya Kawada, PhD, Yoshinori Suzuki, PhD, Kazuyuki Yamamoto, Kurumi Iwaki, Hiroyuki Katoh, PhD

Tnan Hospital

BACKGROUND:
Single incision laparoscopic surgery is an advance where in laparoscopic surgery is carried out through a single small incision hidden in the umbilicus. Advantages of this technique over standard laparoscopy are still under investigation. The objective of this study is to describe the short term outcomes of single port access (SPATM) total gastrectomy in a single community based institution.

METHOD:
Single-port laparoscopic total gastrectomy with D1 lymphadenectomy was successfully performed using a transumbilical single incision. Straight and prevended tipped laparoscopes were used to obtain off-axis views of the operative field. A flexible tipped stapler and curved instruments were used to reconstruct Roux en Y esophagojejunostomy. The procedure was performed without compromising standard, oncological principles. A total of 3 cases diagnosed with gastric cancer.

RESULT:
The average surgical time was about 210 minutes.. In almost all operations, we successfully managed to get an adequate operative field. There were no additinal trocar in single port surgery cases. Proximal and distal resection margins were tumor free. Furthermore, 36 tumor-free lymph nodes on an average were harvested. The patient was discharged on postoperative day 9.

CONCLUSIONS:
SPATM appears to be a promising alternative to conventional laparoscopic total gastrectomy with acceptable. This operation could be safely performed today with prevended instrumentation. Further improvements in the instrumentation should improve the outcomes and adoption of this procedure.


Session: Poster Presentation

Program Number: P521

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