Journal
AMERICAN JOURNAL OF SURGERY
Volume 189, Issue 2, Pages 178-183Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2004.09.008
Keywords
laparoscopy; gastric cancer; Roux-Y reconstruction; intracorporeal anastomosis
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Background: 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. Methods: 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. Results: Roux-Y reconstruction was successfully accomplished without torsion of the loop in all patients. Conclusions: By using the present technique, intracorporeal Roux-Y reconstruction after LDG can be accomplished without a risk of twisting the jejunal loop. (C) 2005 Excerpta Medica Inc. All rights reserved.
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