J Minim Invasive Surg.  2018 Dec;21(4):180-182. 10.7602/jmis.2018.21.4.180.

Omental Free Shaped Flap Reinforcement on Anastomosis and Dissected Area (OFFROAD) Following Gastrectomy

• Han W
• Park K
• Kim DH
• Kim YW

• KMID: 2429392
• DOI: http://doi.org/10.7602/jmis.2018.21.4.180

Abstract

The frequency of anastomotic leakage after gastrectomy is reported to be 0.9~8%. To reduce deleterious outcomes of anastomotic leakage, we devised the "Omental Free-shaped Flap Reinforcement On Anastomosis and Dissected area" procedure not only to prevent fatal complications following anastomotic leakage but also to promote vascularity of anastomoses and other expected oncological benefits. This video illustrates the surgical procedure following a totally laparoscopic distal gastrectomy. After completion of the anastomosis, the remaining omentum was mobilized upward and divided into two sections. We placed the left section of the omental flap under the anastomosis between the stomach and pancreas. Finally, we grasped and curved the tip of the section to cover the anastomosis from behind, and we placed the right section of the omental flap above the anastomosis. These two sections were approximated with clips to the anterior wall of the stomach. The patient was discharged without complications.

Keyword

Gastrectomy; Gastric cancer; Leakage; Anastomosis; Omental flap

MeSH Terms

Anastomotic Leak
Gastrectomy*
Hand Strength
Humans
Omentum
Pancreas
Stomach
Stomach Neoplasms