Modified hemi-double-stapling technique combined with the temporal abdominal wall-lift method for performing Billroth I anastomosis after laparoscopically assisted distal gastrectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2008-12

AUTHORS

Hidenori Fujii, Toshiharu Aotake, Yoshiyuki Kawakami, Yukihiro Okuda, Koji Doi, Yuki Hirose, Toshio Matsushita

ABSTRACT

The authors have used a modified hemi-double-stapling (HDS) technique for reconstruction after laparoscopically assisted distal gastrectomy. The stomach is resected from the greater curvature side using a linear stapler inserted into the stomach from that side at a position vertical to the line of the greater curvature. Resection of the stomach is performed by extending the resection line to the lesser curvature using laparoscopic coagulating shears. The resected specimen is examined. After placement of a purse-string suture at the duodenal stump, an anvil is inserted into the stump, and an additional suture with 2-0 silk is placed over the purse-string suture. A curved intraluminal stapler (CDH25) is inserted into the stomach through the opening made on the lesser curvature side, and the center rod of the stapler is passed through the gastric wall on the corner of the resection line at the greater curvature. Ligation with 2-0 silk is added to the center rod by suturing the gastric tissue 5-8 mm from the center rod to encircle it. The authors call this the "one-knot setup HDS," and with this method, a large-caliber anastomosis is secured. In many cases, it is difficult to observe the anastomotic site through the small incisional opening. However, under laparoscopy with the temporal abdominal wall-lift method using the Multi Flap Gate, the anastomotic site can be easily and safely observed. One-knot setup HDS combined with the temporal abdominal wall-lift method is considered a safe and simple method for performing Billroth I anastomosis in laparoscopic distal gastrectomy. More... »

PAGES

2748-2752

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-008-9833-z

DOI

http://dx.doi.org/10.1007/s00464-008-9833-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1004388437

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/18324439


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