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Solo Intracorporeal Esophagojejunostomy Reconstruction Using a Laparoscopic Scope Holder in Single-Port Laparoscopic Total Gastrectomy for Early Gastric Cancer.

Ahn SH, Son SY, Jung do H, Park YS, Shin DJ, Park do J, Kim HH - J Gastric Cancer (2015)

Bottom Line: However, this is not a popular procedure primarily because of the technical difficulties involved in achieving consistent intracorporeal esophagojejunostomy.At Seoul National University Bundang Hospital, we recently introduced a simple, easy-to-use, low-profile laparoscopic manual scope holder that enables the maintenance of a stable field of view, the most demanding condition in single-port gastrectomy.In this technical report, we describe in detail the world's first solo single-incision laparoscopic total gastrectomy with D1+ lymph node dissection and intracorporeal esophagojejunostomy for proximal early gastric cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

ABSTRACT
Single-incision laparoscopic total gastrectomy for gastric cancer has recently been reported by Seoul National University Bundang Hospital. However, this is not a popular procedure primarily because of the technical difficulties involved in achieving consistent intracorporeal esophagojejunostomy. At Seoul National University Bundang Hospital, we recently introduced a simple, easy-to-use, low-profile laparoscopic manual scope holder that enables the maintenance of a stable field of view, the most demanding condition in single-port gastrectomy. In this technical report, we describe in detail the world's first solo single-incision laparoscopic total gastrectomy with D1+ lymph node dissection and intracorporeal esophagojejunostomy for proximal early gastric cancer.

No MeSH data available.


Related in: MedlinePlus

Semi-loop esophagojejunostomy in solo single-incision laparoscopic total gastrectomy. (A) Inserting the stapler by pulling the jejunum. (B) Inserting the anvil side by pulling the stay suture or the esophagus. (C) A corner stay suture at the near side of the stapling site that can be used during suturing. (D) A barbed suture closure at the far side of the stapling site. (E) A seromuscular suture made using the same barbed thread. (F) Complete view of the solo semi-loop esophagojejunostomy.
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Figure 4: Semi-loop esophagojejunostomy in solo single-incision laparoscopic total gastrectomy. (A) Inserting the stapler by pulling the jejunum. (B) Inserting the anvil side by pulling the stay suture or the esophagus. (C) A corner stay suture at the near side of the stapling site that can be used during suturing. (D) A barbed suture closure at the far side of the stapling site. (E) A seromuscular suture made using the same barbed thread. (F) Complete view of the solo semi-loop esophagojejunostomy.

Mentions: First, the stapler side of a linear stapler was inserted into the jejunal opening with a motion similar to that of pulling up socks; the stapler side could then easily enter the jejunum without separate human assistance. The jaw of the linear stapler was partially closed to prevent the jejunum slipping from the stapler (Fig. 4A). The anvil side of the linear stapler was finally inserted into the opening in the esophagus while the traction suture was controlled with the grasper. By maintaining friction between the two serosal surfaces, it is possible to pull either the esophagus or jejunum using the grasper to adjust the length as needed. In general, a first stapling with a 3-cm length is adequate for preventing stenosis (Fig. 4B).


Solo Intracorporeal Esophagojejunostomy Reconstruction Using a Laparoscopic Scope Holder in Single-Port Laparoscopic Total Gastrectomy for Early Gastric Cancer.

Ahn SH, Son SY, Jung do H, Park YS, Shin DJ, Park do J, Kim HH - J Gastric Cancer (2015)

Semi-loop esophagojejunostomy in solo single-incision laparoscopic total gastrectomy. (A) Inserting the stapler by pulling the jejunum. (B) Inserting the anvil side by pulling the stay suture or the esophagus. (C) A corner stay suture at the near side of the stapling site that can be used during suturing. (D) A barbed suture closure at the far side of the stapling site. (E) A seromuscular suture made using the same barbed thread. (F) Complete view of the solo semi-loop esophagojejunostomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496440&req=5

Figure 4: Semi-loop esophagojejunostomy in solo single-incision laparoscopic total gastrectomy. (A) Inserting the stapler by pulling the jejunum. (B) Inserting the anvil side by pulling the stay suture or the esophagus. (C) A corner stay suture at the near side of the stapling site that can be used during suturing. (D) A barbed suture closure at the far side of the stapling site. (E) A seromuscular suture made using the same barbed thread. (F) Complete view of the solo semi-loop esophagojejunostomy.
Mentions: First, the stapler side of a linear stapler was inserted into the jejunal opening with a motion similar to that of pulling up socks; the stapler side could then easily enter the jejunum without separate human assistance. The jaw of the linear stapler was partially closed to prevent the jejunum slipping from the stapler (Fig. 4A). The anvil side of the linear stapler was finally inserted into the opening in the esophagus while the traction suture was controlled with the grasper. By maintaining friction between the two serosal surfaces, it is possible to pull either the esophagus or jejunum using the grasper to adjust the length as needed. In general, a first stapling with a 3-cm length is adequate for preventing stenosis (Fig. 4B).

Bottom Line: However, this is not a popular procedure primarily because of the technical difficulties involved in achieving consistent intracorporeal esophagojejunostomy.At Seoul National University Bundang Hospital, we recently introduced a simple, easy-to-use, low-profile laparoscopic manual scope holder that enables the maintenance of a stable field of view, the most demanding condition in single-port gastrectomy.In this technical report, we describe in detail the world's first solo single-incision laparoscopic total gastrectomy with D1+ lymph node dissection and intracorporeal esophagojejunostomy for proximal early gastric cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

ABSTRACT
Single-incision laparoscopic total gastrectomy for gastric cancer has recently been reported by Seoul National University Bundang Hospital. However, this is not a popular procedure primarily because of the technical difficulties involved in achieving consistent intracorporeal esophagojejunostomy. At Seoul National University Bundang Hospital, we recently introduced a simple, easy-to-use, low-profile laparoscopic manual scope holder that enables the maintenance of a stable field of view, the most demanding condition in single-port gastrectomy. In this technical report, we describe in detail the world's first solo single-incision laparoscopic total gastrectomy with D1+ lymph node dissection and intracorporeal esophagojejunostomy for proximal early gastric cancer.

No MeSH data available.


Related in: MedlinePlus