Single-incision laparoscopic total gastrectomy with D1+beta lymph node dissection for proximal early gastric cancer

Ahn, Sang Hoon; Park, Do Joong; Son, Sang‐Yong; Lee, Chang Min; Kim, Hyung‐Ho

doi:10.1007/s10120-013-0268-4

Cited by 35 publications

(25 citation statements)

References 10 publications

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“…They started pure single-incision laparoscopic distal and total gastrectomy for early gastric cancer in November 2012 [7]. In some cases, we have encountered the need for D2 LND because of unexpected LN enlargement that may be present even in early-stage gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

“…A 10-mm flexible high-definition scope (Endoeye flexible HD camera system, Olympus Medical Systems Co., Tokyo, Japan), a Harmonic Scalpel (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA), and a LigaSure 5-mm Blunt Tip (Covidien, Mansfield, MA, USA) were used to visualize nearly the same field as that observed in conventional laparoscopic gastrectomy and to facilitate dissection and bleeding control. The detailed procedures, including a modified combined suture retraction of the liver, partial omentectomy, and LND for LNs 6, 5, 12a, 8a, and 7, have been described in our previous reports [7]. …”

Section: Surgical Techniquementioning

confidence: 99%

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Pure single-incision laparoscopic D2 lymphadenectomy for gastric cancer: a novel approach to 11p lymph node dissection (midpancreas mobilization)

et al. 2014

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We developed a novel approach to perform a perfect 11p lymph node dissection (LND), the so-called 'midpancreas mobilization' (MPM) method. Briefly, in pure single-incision laparoscopic distal gastrectomy (SIDG), after the completion of 7, 8a/12a, and 9 LND in the suprapancreatic portion, we started 11p LND after midpancreas mobilization. After mobilization of the entire midpancreas from the white line of Toldt, two gauzes were inserted behind the pancreas. This maneuver facilitated exposure of the splenic vein and complete detachment of soft tissue, including 11p lymph nodes, from the white line of Toldt, which was possible because of the tilting of the pancreas. The dissection plane along the splenic artery and vein for 11p LND could be visualized just through control of the operator's grasper without the need of an assistant. Fourteen patients underwent the procedure without intraoperative events, conversion to conventional laparoscopy, or surgery-related complications, including postoperative pancreatic fistula. All patients underwent D2 LND by exposure of the splenic vein. The mean numbers of retrieved lymph node and 11p lymph node were 61.3 ± 9.0 (range, 49-70), and 4.00 ± 3.38 (range, 1-10). Thus, we concluded that MPM for 11p LND in pure SIDG appears feasible and embryologically ideal; this method can be used in conventional laparoscopic gastrectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Pure single-incision laparoscopic D2 lymphadenectomy for gastric cancer: a novel approach to 11p lymph node dissection (midpancreas mobilization)

et al. 2014

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“…The case report of pure single incision total gastrectomy for proximal early gastric cancer was firstly reported in 2014 (50). Collision of each instrument is expected to be more serious and making good surgical field also more difficult, however authors reported similar operation outcome compared to conventional multiport laparoscopic total gastrectomy.…”

Section: Single Incision Total Gastrectomymentioning

confidence: 99%

Single incision gastrectomy for gastric cancer

Suh

Lee

Yang

2016

Transl. Gastroenterol. Hepatol.

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Based on rapid development of laparoscopic techniques and instruments, single-incision laparoscopic surgery (SILS) is expected to be the next step of "more" minimally invasive surgery. A few institutions gradually started to report their experience of single incision gastrectomy (SIG) for gastric cancer, but it is still difficult to accept that SIG can be performed as a popular procedure because of its technical difficulty. For wide adoption of SIG, the simplicity, safety and reproducibility of not only lymph node dissection but also reconstruction should be evaluated compared to a conventional procedure. With a thorough understanding of unique characteristics of SILS, single incision distal gastrectomy (SIDG) for early gastric cancer performed by laparoscopic surgeons with advanced technique is expected to have promising potential about excellent cosmesis, comparable morbidity and mortality in carefully selected patients. For appropriate adoption and steady progress of this state-of-the art surgery, scientific evaluation with healthy critics is necessary with new generation of SILS instrument platform.

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“…Ahn et al 45 and Ertem et al 46 reported several patients who successfully underwent single-port LTG (Table 5). The surgical outcomes of single-port LTG were not significantly different from those of dual-port LTG or conventional LTG.…”

Section: Dual-port or Single-port Ltgmentioning

confidence: 99%

Laparoscopic Total Gastrectomy for Gastric Cancer

Jung

Kim

2015

J Minim Invasive Surg

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Laparoscopic total gastrectomy (LTG) has been more widely performed in the last decade because of improvements in the techniques and safety of laparoscopic distal gastrectomy. However, due to its technical difficulty, there are still concerns regarding the safety of LTG. Meta-analyses have shown that LTG is technically feasible, safe, and may offer advantages over open total gastrectomy for treatment of gastric cancer. Various methods of performing esophagojejunostomy have been developed in an effort to decrease the rate of anastomosis-related complications, and have ultimately improved the safety and acceptance of LTG. However, there is still a lack of level-one evidence in support of LTG. Conduct of large-scale, randomized clinical trials will be needed in order to verify the safety and efficacy of LTG. Therefore, we reviewed the current status and some of the controversies surrounding LTG.

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Single-incision laparoscopic total gastrectomy with D1+beta lymph node dissection for proximal early gastric cancer

Cited by 35 publications

References 10 publications

Pure single-incision laparoscopic D2 lymphadenectomy for gastric cancer: a novel approach to 11p lymph node dissection (midpancreas mobilization)

Pure single-incision laparoscopic D2 lymphadenectomy for gastric cancer: a novel approach to 11p lymph node dissection (midpancreas mobilization)

Single incision gastrectomy for gastric cancer

Laparoscopic Total Gastrectomy for Gastric Cancer

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