Shinichi Sakuramoto, PhD, Hisashi Gunji, PhD, Motohiro Tyuuman, MD, Kenichi Aratani, MD, Mistuo Wakata, MD, Yutaka Miyawaki, PhD, Hiroshi Sato, PhD, Koujun Okamoto, PhD, Shigeki Yamaguchi, PhD, Isamu Koyama, PhD. Saitama Medical University, International Medical Center
INTRODUCTION: During esophagojejunostomy using a circular stapler after 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.
METHODS AND PROCEDURES: Between January 2013 and August 2016, esophagojejunostomy was performed using OrVil in 78 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: Esophagojejunal anastomosis 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 2 patients, in whom mild relief was achieved using a bougie.
CONCLUSION: Esophagojejunostomy using the transoral pretilted anvil head is a simple and safe technique.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79481
Program Number: P588
Presentation Session: Poster (Non CME)
Presentation Type: Poster
