Shinichi Sakuramoto, PhD, Motohiro Chyuman, MD, Kenichi Aratani, MD, Masato Kasuya, Hirofumi Sugita, PhD, Yutaka Miyawaki, PhD, Hiroshi Sato, PhD, Koujun Okamoto, Shigeki Yamaguchi, Isamu Koyama. Saitama University, International Medical Center
INTRODUCTION: During esophagojejunostomy using a circular stapler after laparoscopy assisted total gastrectomy (LATG), placement of the anvil head via the transabdominal approach proved difficult. The authors report on a method modified for laparoscopy-assisted, esophagojejunostomy performed by placing the pretilted anvil head(OrVil) via the transoral approach.
MESODS AND PROCEDURES: Between January 2013 and August 2017, esophagojejunostomy was performed using OrVil in 98 patients after LATG. The anesthesiologist introduced the anvil while observing its passage through the pharynx. During the anastomosis, we kept the jejunum fixed in position with a silicone band Lig-A-Loops, thereby preventing the intestine from slipping off the shaft of the stapler.
RESULTS: Esophagojejunostomy using the OrVil was achieved successfully in all patients. No other complications, such as hypopharyngeal perforation and/or esophageal mucosal injury, occurred during passage. The postoperative complications of anastomosis were leakage in two patients and stenosis in 4 patients, in whom mild relief was achieved using a bougie.
CONCLUSION: Esophagojejunostomy using the OrVil is a simple and safe technique.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86979
Program Number: P722
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster