Chaya Shwaartz, Nadav Zilka, MD, Lyn Gilad, MD, Yuri Goldes, MD. Sheba Medical Center, Israel
This is a video presentation on laparoscopic D2 total gastrectomy for gastric cancer. A 62-year-old male, presented to the office following an upper endoscopy revealing gastric carcinoma. Imaging showed no metastatic disease. The patient was taken to the operating room for laparoscopic D2 subtotal gastrectomy.
After performing a D2 subtotal gastrectomy the specimen was sent to a frozen section that revealed no tumor. At this point the patient underwent completion for total gastrectomy following a multidisciplinary consultation. The surgery was uneventful. Post operatively the patient was doing well. However, he presented to the emergency room a month after surgery with fever and mild abdominal pain. A CT scan showed a small collection and the patient was treated with antibiotics. In this case, we show, that laparoscopic surgery for gastric cancer can be safe and feasible when performed by an experienced surgeon.
The pitfalls in these cases is avoiding injury to the mesocolon while separating the omentum, avoiding injury to the pancrease and duodenum while performing the lymphadenectomy and avoiding tenting of the common hepatic artery while dissecting the right gastric artery, taking note that there is no replaced left hepatic artery while dissecting the left gastric artery. Careful dissection at the mediastinum while dissecting the esophagus is crucial. Laparoscopic D2 gastrectomy is feasible. However, patient selection is of great importance.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87373
Program Number: V036
Presentation Session: Foregut Videos Session
Presentation Type: Video