Technical details of gastrointestinal reconstruction using linear stapler in totally laparoscopic total gastrectomy.
10.3760/cma.j.cn441530-20220309-00096
- VernacularTitle:完全腹腔镜全胃切除术中线型吻合器法消化道重建及其技术细节
- Author:
Xian Li HE
1
;
Peng GAO
1
;
Nan WANG
1
Author Information
1. Department of General Surgery, The Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China.
- Publication Type:Journal Article
- Keywords:
Esophagojejunostomy;
Laparoscopy;
Stomach neoplasms;
Total gastrectomy
- MeSH:
Anastomosis, Surgical/methods*;
Gastrectomy/methods*;
Humans;
Jejunum/surgery*;
Laparoscopy/methods*;
Stomach Neoplasms/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(5):378-384
- CountryChina
- Language:Chinese
-
Abstract:
With the development of instrument, equipment and surgical skills, especially the emergence of a series of high-level medical evidence, the laparoscopic techniques in the field of gastric surgery has been further expanded. Totally laparoscopic total gastrectomy (TLTG) has certain technical difficulties, and more challenges are reflected in the digestive tract reconstruction. The use of linear staplers has reduced the difficulty of digestive tract reconstruction to a certain extent and has strongly promoted the transition from laparoscopic-assisted total gastrectomy to TLTG. However, for TLTG, there are still many details that should be carefully concerned, so as to effectively avoid the surgical pitfalls and ensure the fluency and safety of the procedure. In this article, we discuss the surgical details based on our own experiences, including how to obtain surgical field exposure well, how to manage specific accidents when using linear stapler for esophagojejunostomy, how to prevent intra-abdominal hernias and Roux stasis syndrome, and how to prevent the stapled lines of the esophageal or jejunal stumps from direct contact with aorta.
