Intraoperative gastroscopy for gastric surgery

Park, Do Joong; Lee, Hyuk‐Joon; Kim, Sang Gyun; Jung, Hyun-Kyo; Song, In Sang; Lee, K. U.; Choe, Kuk Jin; Yang, Han‐Kwang

doi:10.1007/s00464-004-2217-0

Cited by 53 publications

(49 citation statements)

References 16 publications

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“…The appropriate line of the proximal resection margin is usually guided by the clip, which is placed preoperatively or by intraoperative gastroscopy [13]. The greater curvature side of the proximal resection margin is transected with a linear stapler (GIA-60; Auto Suture Co.).…”

Section: Methodsmentioning

confidence: 99%

Safety of modified double‐stapling end‐to‐end gastroduodenostomy in distal subtotal gastrectomy

Yang

Lee

Ahn

et al. 2007

Journal of Surgical Oncology

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Section: Methodsmentioning

confidence: 99%

Safety of modified double‐stapling end‐to‐end gastroduodenostomy in distal subtotal gastrectomy

Yang

Lee

Ahn

et al. 2007

Journal of Surgical Oncology

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“…So far, in the clinical setting, several techniques for intraoperative identification of the tumor have been reported, such as preoperative or intraoperative tattooing [8,14], intraoperative endoscopy [15], intraoperative radiography [9,16], and intraoperative ultrasonography [7]. Preoperative tattooing with dye injection is probably the simplest of these, and is often used in colon surgery [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Simple and reliable method for tumor localization during totally laparoscopic gastrectomy: intraoperative laparoscopic ultrasonography combined with tattooing

et al. 2016

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We have developed a new method to localize a tumor during totally laparoscopic gastrectomy that uses intraoperative laparoscopic ultrasonography combined with preoperative clipping and tattooing. One or 2 days before the surgery, endoscopic clipping was performed just proximal to the tumor, followed by tattooing with India ink at the clipping site. Examination by intraoperative laparoscopic ultrasonography was performed at the tattooed site to detect the clips. The resection line of the stomach was determined with use of the detected clips as a marker of the proximal margin of the tumor. This method was attempted in 14 patients who underwent totally laparoscopic gastrectomy, and the clips were successfully identified in all patients. The clips were visualized as several layers of a hyperechoic bar, which was termed a ''ladder sign.'' The mean time from insertion of the laparoscopic probe to identification of the clips was 2 min. The ladder sign is an important finding in this method.

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“…gastrectomy [16,19] . Although few reports have described the transection time including the time for gastroscopy [14] , we believe the transection achieved using GRREG for TLDG was acceptable and beneficial. Of note, it is important to pay careful attention to avoid the distention of the stomach when the gastroscope is being passed through the narrowed lumen.…”

Section: Discussionmentioning

confidence: 99%

“…However, the definitive method for gastric transection with a safe cancer margin has not been established fully, especially for patients with early gastric cancer in the middle or upper stomach. Some reports have advocated the usefulness of intraoperative gastroscopy [14][15][16][17][18] with preoperative marking using metal clips. Nevertheless, there are concerns with regard to utilizing the normal gastroscopic forward view.…”

Section: Discussionmentioning

confidence: 99%

Gastric Resection Under Retroflexed Endoscopic Guidance: A Reliable Procedure for Totally Laparoscopic Subtotal Gastrectomy

Gunji

Horibe²,

Uesato³

et al. 2016

Dig Surg

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Background/Aims: Totally laparoscopic distal gastrectomy (TLDG) has become a feasible and safe surgical option for early gastric cancer. However, determining the transection line of the stomach without palpation is still difficult. This study aimed to assess the efficacy of TLDG for gastric resection under retroflexed endoscopic guidance (GRREG) in patients with gastric cancer in the middle third of the stomach. Methods: Fifteen patients with gastric cancer underwent TLDG using GRREG. Preoperative tumor localization using endoscopic metal clips was performed in all cases. After lymphadenectomy, two-thirds of the estimated transection line was occluded by an endoscopic stapler, beginning at the lesser curvature. Under gastric occlusion, the gastroscope was passed via the narrow lumen along the greater curvature followed by retroflexion to reveal the occlusion line, marking clips, and tumor in the same field of view. This view verified the safe oncological transection line. Results: All patients had cancer-free margins and did not require additional surgery. The mean (±SD) proximal margin was 23.5 ± 10.4 mm. There were no procedure-related complications. Conclusions: GRREG was a safe and effective technique for TLDG. Ideal transection of the stomach was achieved using a combination of an endoscopic stapler and gastroscope retroflexion.

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Intraoperative gastroscopy for gastric surgery

Abstract: Intraoperative gastroscopy can be used effectively during gastric surgery for early gastric cancer or submucosal tumors and can be regarded as a modern stethoscope to gastric surgeons.

Cited by 53 publications

References 16 publications

Safety of modified double‐stapling end‐to‐end gastroduodenostomy in distal subtotal gastrectomy

Safety of modified double‐stapling end‐to‐end gastroduodenostomy in distal subtotal gastrectomy

Simple and reliable method for tumor localization during totally laparoscopic gastrectomy: intraoperative laparoscopic ultrasonography combined with tattooing

Gastric Resection Under Retroflexed Endoscopic Guidance: A Reliable Procedure for Totally Laparoscopic Subtotal Gastrectomy

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