Endoscopy-Assisted Laparoscopic Resection of the Gastric Wall Facilitated by a Double-Lifting Method

Because of the increased incidence of early gastric cancer in Japan, minimally invasive laparoscopic approaches to gastric malignancies have been under development since 1991. Laparoscopic local resection of the stomach, i.e., laparoscopic wedge resection (LWR) and intragastric mucosal resection (IGMR), is used to treat mucosal cancer without lymph node metastasis. Laparoscopy-assisted distal gastrectomy (LADG) is used to treat early gastric cancer with risk factors for regional lymph node metastasis. A survey conducted by the Japan Society for Endoscopic Surgery showed that 1428 LWRs, 260 IGMRs, and 2600 LADGs were performed between 1991 and 2001 in departments of endoscopic surgery in Japan. Laparoscopic gastrectomy for gastric cancer is still under development in Japan. According to short-term results reported by a small group of surgeons, laparoscopic approaches to gastric cancer provide for minimal invasion, early recovery, and decreased morbidity and mortality. If the advantages can be confirmed in one or more multicenter randomized control studies of the long-term outcome of patients undergoing laparoscopic gastrectomy for gastric cancer, the procedure should come into wide acceptance and use.

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“…To resect the lesion successfully, Altorjay et al developed the modified lesion-lifting method called the double-lifting method [4].…”

Section: Indicationsmentioning

confidence: 99%

Current status of laparoscopic gastrectomy for cancer in Japan

2004

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“…Recently, the laparoscopic resection of such tumors has been reported by several authors [11 ± 14]. Other working groups have described the use of intraluminal gastroscopy to assist laparoscopic resection [3,15]. The anatomical location of the tumor was the key consideration in the decision to use the technique we describe here.…”

Section: Discussionmentioning

confidence: 99%

A Technique for Endo-Organ Resection of Gastric Wall Tumors Using One Intragastric Trocar

Pross

Wolff²,

Nestler³

et al. 2003

Endoscopy

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This report describes a new technique for combined laparoscopic and gastroscopic intragastric resection of benign gastric wall tumors. We performed this combined endo-organ procedure in five patients. Endo-organ intragastric resection is only used with posterior gastric wall tumors and tumors located near the cardia and the pylorus. For this approach, only one trocar is placed into the stomach for intragastric introduction of the endostapler. The video gastroscope allows intragastric vision. We recommend our procedure for the extirpation of small, benign, intramural gastric tumors, as a safe and very comfortable method for the patient.

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“…There are three procedures for the management of EGC: (1) laparoscopic wedge resection (LWR) [23,24] , (2) intragastric mucosal resection (IGMR) [25] , and (3) laparoscopic gastrectomy (totally laparoscopic, laparoscopy-assisted, and hand-assisted). Since our fi rst experience doing laparoscopy-assisted distal gastrectomy (LADG) by a Billroth I reconstruction for a patient with EGC in 1991 [26] , a national survey conducted by the Japan Society of Endoscopic Surgery (JSES) showed increasing use of laparoscopic procedures for EGC in Japan.…”

Section: Laparoscopic Gastrectomy For Early Gastric Cancer Current Trmentioning

confidence: 99%

Laparoscopic Gastrectomy for Cancer

Etoh

Shiraishi²,

Kitano³

2005

Dig Dis

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There are three procedures for the management of early gastric cancer (EGC): laparoscopic wedge resection (LWR), intragastric mucosal resection (IGMR), and laparoscopic gastrectomy. LWR or IGMR can be applied to treat EGC without the risk of lymph node metastasis. However, owing to the recent technical advances in endoscopic mucosal resection for EGC, the use of laparoscopic local resection for these lesions has gradually decreased. On the other hand, laparoscopic gastrectomy with lymph node dissection, such as laparoscopy-assisted distal gastrectomy, is widely accepted for the treatment of EGC with the risk of lymph node metastasis. To establish the acceptability of laparoscopic gastrectomy with D2 lymph node dissection against advanced gastric cancers, safe techniques and new instruments must be developed. The following advantages of laparoscopic surgery for the treatment of gastric cancer have been well demonstrated: clinical course after operation, pulmonary function, immune response. In the future, laparoscopic surgeons have to design and implement education and training systems for standard laparoscopic procedures, evaluate clinical outcomes by multicentric randomized control trial studies, and clarify the oncological aspects of laparoscopic surgery in basic studies.

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Endoscopy-Assisted Laparoscopic Resection of the Gastric Wall Facilitated by a Double-Lifting Method

Cited by 4 publications

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Current status of laparoscopic gastrectomy for cancer in Japan

Current status of laparoscopic gastrectomy for cancer in Japan

A Technique for Endo-Organ Resection of Gastric Wall Tumors Using One Intragastric Trocar

Laparoscopic Gastrectomy for Cancer

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