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Surg Endosc. 2018 Oct;32(10):4344-4350. doi: 10.1007/s00464-018-6244-7. Epub 2018 May 21.

Intracorporeal delta-shaped gastroduodenostomy in reduced-port robotic distal subtotal gastrectomy: technical aspects and short-term outcomes.

Lee JH1, Son T2,3,4, Kim J5, Seo WJ5,6, Rho CK5,6, Cho M5,6, Kim HI5,6,7, Hyung WJ5,6,7.

Author information

1
Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
2
Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. tison@yuhs.ac.
3
Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea. tison@yuhs.ac.
4
Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea. tison@yuhs.ac.
5
Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
6
Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea.
7
Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.

Abstract

BACKGROUND:

Gastroduodenostomy is preferred as a method of reconstruction following distal subtotal gastrectomy. However, in initial reports on reduced-port gastrectomy, gastroduodenostomy has rarely been performed therein because of technical difficulties. The present study describes a novel intracorporeal gastroduodenostomy technique applicable during reduced-port robotic distal subtotal gastrectomy.

METHODS:

Data were retrospectively reviewed for cases of reduced-port (three-port) robotic distal subtotal gastrectomy with intracorporeal delta-shaped gastroduodenostomy performed from February 2016 to December 2016. The reduced-port approach used a Single-Site™ port via a 25-mm infraumbilical incision and two additional ports. We performed intracorporeal gastroduodenostomy using a 45-mm robotic or laparoscopic endolinear stapler. All staplers were inserted via a port on the left lower abdomen.

RESULTS:

In our initial experience with intracorporeal gastroduodenostomy, 28 consecutive patients underwent successful surgery with the technique without needing to convert to open, laparoscopic, or conventional five-port robotic surgery. Mean operation time was 201.1 min (110-282 min), and no major complications, including anastomosis-related problems, were recorded.

CONCLUSIONS:

Intracorporeal delta-shaped gastroduodenostomy was safely and feasibly applied during reduced-port robotic gastrectomy with acceptable operative outcomes and no major complications. Intracorporeal gastroduodenostomy should be considered during reduced-port distal subtotal gastrectomy.

KEYWORDS:

Gastric cancer; Gastroduodenostomy; Reduced-port surgery; Robot stapler

PMID:
29785459
DOI:
10.1007/s00464-018-6244-7

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