Laparoscopic Pylorus Preserving Gastrectomy with Intra-Corporeal Gastro-Gastrostomy Guided by Intra-Operative Gastroscopy

Abstract

Gastric cancer detection is advancing to a point where screening programs can detect gastric cancer at early stages. This allows surgical procedures to be less radical than before. Studies have proven that pylorus preserving gastrectomy is a safe procedure in early T1a and T1b gastric cancers where the tumour location is in the middle third of the stomach. However, due to the small tumour size, determining an appropriate resection margin can be challenging. A few techniques have been developed to overcome this difficulty, and at our centre, we perform intra-operative gastroscopy to synchronize with the laparoscopic view and precisely determine the tumour location for optimal gastric resections. This allows the gastrectomy to be performed safely and prevents inadequate resection leaving tumour cells behind. This video is aimed at sharing our experience in performing pylorus-preserving gastrectomy.