Jejunal Interposition after Totally Laparoscopic Proximal Gastrectomy Using Overlap Method
Iwanaga, T.; Tsukamoto, Y.; Yamamoto, S.; Hamaguchi, H.; Katsumori, T.; Ohshima, H.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 44(12): 1538-1540
2017
ISSN/ISBN: 0385-0684 PMID: 29394694 Document Number: 694351
There are several reconstruction methods in laparoscopic proximal gastrectomy(LPG)for earlygastric cancer at the upper part of the stomach. To prevent the esophageal reflux after gastrectomy, we chose jejunal interposition(JI)via the retrocolic route for LPG. We performed totallyLPG with JI using overlap method. Five ports were placed. After the lymph nodes dissection bythe standard procedure, the esophagus and the proximal side of the stomach were transected byliner staplers. The jejunum was moved to the upper abdomen through the small hole of the mesocolon. The interposing jejunum was made, and the esophagojejunostomyand jejunogastrostomywere done byusing overlap method. At the end, the jujunum was pulled under the mosocolon escluding the interposing jejunum. The JI reconstruction via a retrocolic route after LPG was completed. Following LPG, the JI reconstruction is not so popular because the surgical procedure is complicated. In our technique, the JI reconstruction accomplished easier byoverlap method. Our procedure is a considerable operation of reconstruction following LPG.