J Gastric Cancer.  2016 Sep;16(3):200-206. 10.5230/jgc.2016.16.3.200.

Single-Port Laparoscopic Proximal Gastrectomy with Double Tract Reconstruction for Early Gastric Cancer: Report of a Case

• Lee CM
• Park DW
• Jung DH
• Jang YJ
• Kim JH
• Park S
• Park SH

• KMID: 2372565
• DOI: http://doi.org/10.5230/jgc.2016.16.3.200

Abstract

In Korea, proximal gastrectomy has recently attracted attention as a better choice of function-preserving surgery for proximal early gastric cancer than total gastrectomy. Of the various strategies to overcome reflux symptoms from remnant stomach, double tract reconstruction not only reduces the incidence of anastomosis-related complications, but is also sufficiently reproducible as a laparoscopic procedure. Catching up with the recent rise of single-port laparoscopic surgeries, we performed a pure single-port laparoscopic proximal gastrectomy with DTR. This procedure was designed by merging the function-preserving concept of proximal gastrectomy with single-port laparoscopic total gastrectomy.

Keyword

Stomach neoplasms; Single port; Laparoscopy; Gastrectomy

MeSH Terms

Gastrectomy*
Gastric Stump
Incidence
Korea
Laparoscopy
Stomach Neoplasms*

Figure

• 

  Fig. 1 The procedures during lymph node dissection. (A) Opening of the lesser sac. (B) Lymph node station No. 8a (RGA = right gastric artery; CHA = common hepatic artery). (C) Division of stomach with linear staper. (D) Lymph node station No. 11p. (E) Division of esophagus with linear stapler.

• 

  Fig. 2 The details of esophgojejunostomy. (A) Esophagojejunostomy with linear stapler. (B) Closure of common entry hole with a barbed suture material.

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  Fig. 3 The schematic diagram of double tract reconstruction. GJ was made 15 cm distal to the EJ, and JJ was made 20 cm distal to the GJ. Efferent loop of jejunum should keep to the right until GJ is made (GJ = gastrojejunostomy; EJ = esophagojejunostomy; JJ = jejunojejunostomy).

• 

  Fig. 4 The postoperative wound. There was no wound problem at the postoperative day 20th.

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