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KMID : 0978820040070020116
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2004 Volume.7 No. 2 p.116 ~ p.121
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Totally Laparoscopic Distal Gastrectomy with D1+α Lymph Node Dissection
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Han Sang-Moon
Cha Seon-Wook
Kim Won-Woo
Jeon Hae-Myung
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Abstract
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Purpose: The first totally laparoscopic gastrectomy was performed in 1992. To date, laparoscopic gastrectomy has been performed by a small number of surgeons around the world. The techniques of laparoscopic gastrectomy with perigastric lymph node dissection in early gastric cancer were reported in many laparoscopic surgery center, however most of them were hand-assisted laparoscopic gastrectomy or laparoscopy-assisted gastrectomy. Here, we have introduced the technique and initial results for totally laparoscopic gastrectomy with extra perigastric lymph node dissection for early gastric cancer.
Methods: Five patients with early gastric cancer underwent totally laparoscopic gastrectomy with extra peri-gastric lymph node dissection. Reconstruction was performed with intracorporeally Billroth-II gastrojejunostomy or Roux-en-Y gastrojejunostomy using EEA (End to side anastomosis) or GIA stapler. Resected specimen was retrieved through 4 cm Pfannenstiel supra-pubic incision.
Results: All laparoscopic gastrectomy technique on gastric cancer were performed successfully without conversion to open. Median dissected lymph node was 17 (range: 3∼29), Operation time was 260 min. (range: 150∼360), and Median postoperative hospital days were 9 days (range: 7∼12). There was no major complication.
Conclusion: We need more cases to analysis the technique emphasis on minimizing the invasive procedure, on laparoscopic gastrectomy and intracorporeal reconstruction can be effective way of treating. The modified operative technique is recommended in early gastric cancer to increase the laparoscopic advantages.
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KEYWORD
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Totally laparoscopic gastrectomy, Intracorporeal reconstruction, Roux-en-Y gastrojejunostomy, B-II gastrojejunostomy
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