| Stable purse-string suturing using an anterior esophagotomy for reconstruction with a circular stapler during laparoscopic total gastrectomy. | |
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MedLine Citation:
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PMID: 23323665 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: During a laparoscopic total gastrectomy, the combined process of purse-string suture placement and anvil insertion of a circular stapler is one of the most difficult steps in the reconstruction. We have developed a stable and reliable technique in which purse-string suture placement and anvil insertion using anterior esophagotomy precede complete transection of the esophagus. METHODS: The procedure involves tying the distal esophagus, insufflating the esophagus via a nasogastric tube, anterior wall purse-string suture, anterior esophagotomy, posterior wall purse-string suture, anvil insertion, fastening purse-string suture, and transecting the esophagus. The technique has been employed in nine patients since April 2011. RESULTS: Eight of the nine gastrectomies were for patients with stage IA early gastric cancer and one was for a patient with medically intractable bleeding from multiple polyps. Three were men and six were women. Average BMI was 25.2 ± 5.3 (range, 16.3-33.9). Mean operation time was 276.2 ± 56.3 min (range, 215.0-395.0 min) and the mean duration for anvil insertion was 29.8 ± 7.0 min (range, 23.0-46.0 min). There were no intraoperative or postoperative anastomosis-related complications or mortality. CONCLUSION: Our method of anvil insertion of a circular stapler can be a good option for safe and reliable esophagojejunostomy during a laparoscopic total gastrectomy. |
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Authors:
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Seong-Ho Kong; Yunsuhk Suh; Sebastianus Kwon; Hyuk-Joon Lee; Hyung-Ho Kim; Han-Kwang Yang |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-17 |
Journal Detail:
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Title: Asian journal of endoscopic surgery Volume: - ISSN: 1758-5910 ISO Abbreviation: Asian J Endosc Surg Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101506753 Medline TA: Asian J Endosc Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd. |
Affiliation:
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Department of Surgery, Seoul National University Hospital, Seoul, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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