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A secure technique of intracorporeal Roux-Y reconstruction after laparoscopic distal gastrectomy

2005; Elsevier BV; Volume: 189; Issue: 2 Linguagem: Inglês

10.1016/j.amjsurg.2004.09.008

1879-1883

Kyoichi Takaori, Eiji Nomura, Hideaki Mabuchi, San-Woong Lee, Tomoyuki Agui, Yoshiharu Miyamoto, Mitsuhiko Iwamoto, Hisashi Watanabe, Nobuhiko Tanigawa,

Metastasis and carcinoma case studies

Laparoscopic distal gastrectomy [LDG] is a minimally invasive surgery for gastric carcinoma. The Billroth I method has been commonly employed to reconstruct alimentary tract after LDG. Conversely, Roux-Y reconstruction is employed far less commonly despite its merits. Technical difficulties, including a risk of twisting the Roux loop under limited vision through a laparoscope, have hampered Roux-Y reconstruction after LDG.We performed LDG and intracorporeal Roux-Y reconstruction in 5 patients with early gastric cancer. The procedure included a functional end-to-end anastmosis of the stomach and jejunum, consisting of side-to-side approximation of jejunal loop to greater curvature of the gastric remnant with a laparoscopic stapling device followed by closure of the open end and simultaneous division of the jejunum with another stapler.Roux-Y reconstruction was successfully accomplished without torsion of the loop in all patients.By using the present technique, intracorporeal Roux-Y reconstruction after LDG can be accomplished without a risk of twisting the jejunal loop.