Lymph Node Dissection Using Bipolar Vessel-Sealing Device During Reduced Port Laparoscopic Distal Gastrectomy for Gastric Cancer: Result of a Pilot Study from a Single Institute

J Laparoendosc Adv Surg Tech A. 2017 Nov;27(11):1101-1108. doi: 10.1089/lap.2016.0685. Epub 2017 Mar 27.

Abstract

Introduction: The electrothermal bipolar vessel-sealing device (BVSD) is known to supply a strong vessel-sealing power. However, only few studies have reported lymph node dissection (LND) using only BVSD during laparoscopic surgery for gastric cancer. The purpose of this study was to investigate the feasibility of LND using BVSD during reduced port laparoscopic distal gastrectomy for gastric cancer.

Methods: From May 2015, patients in whom three- or single-port laparoscopic distal gastrectomy had been engaged for gastric cancer were enrolled in this study. We performed D1+ or D2 LND using only LigaSure Maryland (Medtronics, Minneapolis, MN), a recently developed BVSD. Clinical outcomes of these patients were investigated.

Results: From May 2015 to November 2016, 20 patients were enrolled in this study. The mean operation time was 262.6 ± 36.6 (200-340) minutes. The mean time for LND was 124.7 ± 19.2 (93-171) minutes. Only one patient had a morbidity of Clavien-Dindo grade more than II. No mortality was observed in all patients. The mean number of retrieved lymph nodes was 46.8 ± 22.8 (15-105).

Conclusions: LND using the Maryland jaw type BVSD was feasible during reduced port (single- or three-port) laparoscopic distal gastrectomy for gastric cancer. Objectively evaluating the potential advantages of BVSD in reduced port laparoscopic surgery is necessary.

Keywords: bipolar vessel-sealing device; reduced port laparoscopic surgery; stomach neoplasm.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrectomy / instrumentation*
  • Gastrectomy / methods
  • Humans
  • Laparoscopy / instrumentation*
  • Laparoscopy / methods
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Operative Time
  • Pilot Projects
  • Prospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome
  • Young Adult