Relevance of Reduced-Port Laparoscopic Distal Gastrectomy for Gastric Cancer: A Pilot Study

Abstract

Background/Aims: Single-port and reduced-port laparoscopic surgeries are performed as a less invasive form of surgery than conventional laparoscopy. In this study, short-term patient outcomes were compared between reduced-port laparoscopic distal gastrectomy (RPLDG) and conventional laparoscopy-assisted distal gastrectomy (LADG) to evaluate the feasibility of RPLDG for gastric cancer. Methods: Between August 2010 and July 2011, 38 patients underwent LADGs that were performed by a single surgeon. Of these, 20 patients underwent RPLDG, and 18 patients underwent conventional LADG. Short-term outcomes were compared between the two groups. Results: Surgical procedures, total operation time (278.8 versus 228.7 min, p = 0.0002) and time for lymph node dissection (181.3 versus 136.3 min, p = 0.0001) were significantly longer in the RPLDG group compared with the LADG group, while the volume of blood loss during reconstruction was reduced (17.5 versus 49.6 ml, p = 0.0019). Cosmetic satisfaction in the RPLDG group showed significant superiority over that in the conventional LADG group (p = 0.0252). Conclusion: RPLDG was shown to be an acceptable and satisfactory procedure for the treatment of gastric cancer. To confirm the feasibility of this surgical procedure, it is necessary to conduct a well-designed randomized controlled study comparing RPLDG and conventional LADG in many patients.

Application of reduced-port laparoscopic total gastrectomy in gastric cancer preserving the pancreas and spleen

“…We showed similar surgical outcomes in a previous study for a reduced-port laparoscopic distal gastrectomy (RPLDG) procedure, using a multiaccess port at the umbilicus plus one additional port, compared with conventional LADG (CLADG), using five ports plus a small, 5-cm skin incision [14]. Patients who underwent RPLDG were particularly satisfied with the cosmetic appearance of the surgical wounds.…”

“…An experienced and skillful surgeon can perform such complex laparoscopic gastrectomies after gaining sufficient experience of conventional laparoscopic gastrectomies. In our previous study [14], we also reported satisfactory outcomes for reduced-port (SILS Port TM plus one port) LADG.…”

Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

“…After the benefits of MIS are confirmed in these studies, laparoscopic surgery for EGC could be recognized, not as an investigational approach, but as a standard procedure in clinical practice. With the accumulated and extensive experiences and improved surgical instruments, some surgeons are now focusing on reducing the patient's distress by using reduced ports or a single incision approach for EGC 26,27. Extracorporeal anastomoses using minilaparotomy is being replaced by intracorporeal anastomoses and results in a totally laparoscopic gastrectomy 28,29,30,31,32.…”

“…Technically-demanding procedures such as total gastrectomy with or without splenectomy, gastrectomy with multivisceral resection, and completion total gastrectomy for remnant gastric cancer have been successfully performed by experienced surgeons using minimally invasive approaches 64,65,66,67,68. Single incision or reduced port surgery for gastric cancer also has been reported to be a safe and feasible procedure 26,27. Although this approach is safe and feasible, more evidence that demonstrates efficacy is needed.…”

Dual-Incision Laparoscopic Surgery for Peritoneal Dialysis Catheter Implantation and Fixation: A Novel, Simple, and Safe Procedure

“…[9][10][11] Dual-incision laparoscopic surgery (DILS) has been reported in several surgical fields. [12][13][14][15] Compared with conventional laparoscopic surgery, DILS reduced the number of trocars and offered less pain, shorter length of incision, quicker recovery, and better cosmetic appearance. However, no report has yet been proposed about the effectiveness of DILS in PD catheter implantation (DILS-PD).…”