Intracorporeal delta-shaped gastroduodenostomy in reduced-port robotic distal subtotal gastrectomy: technical aspects and short-term outcomes
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Gastroduodenostomy is preferred as a method of reconstruction following distal subtotal gastrectomy. However, in initial reports on reduced-port gastrectomy, gastroduodenostomy has rarely been performed therein because of technical difficulties. The present study describes a novel intracorporeal gastroduodenostomy technique applicable during reduced-port robotic distal subtotal gastrectomy.
Data were retrospectively reviewed for cases of reduced-port (three-port) robotic distal subtotal gastrectomy with intracorporeal delta-shaped gastroduodenostomy performed from February 2016 to December 2016. The reduced-port approach used a Single-Site™ port via a 25-mm infraumbilical incision and two additional ports. We performed intracorporeal gastroduodenostomy using a 45-mm robotic or laparoscopic endolinear stapler. All staplers were inserted via a port on the left lower abdomen.
In our initial experience with intracorporeal gastroduodenostomy, 28 consecutive patients underwent successful surgery with the technique without needing to convert to open, laparoscopic, or conventional five-port robotic surgery. Mean operation time was 201.1 min (110–282 min), and no major complications, including anastomosis-related problems, were recorded.
Intracorporeal delta-shaped gastroduodenostomy was safely and feasibly applied during reduced-port robotic gastrectomy with acceptable operative outcomes and no major complications. Intracorporeal gastroduodenostomy should be considered during reduced-port distal subtotal gastrectomy.
KeywordsGastroduodenostomy Robot stapler Reduced-port surgery Gastric cancer
This study was supported by a faculty research grant from Yonsei University College of Medicine (6-2016-0109).
JHL and TS designed the study; JHL, JK, WJS, CKR, and TS collected all materials; JHL, JK, and TS drafted the paper; and MC, HIK, and WJH critically revised subsequent drafts. All authors have read and approved the submission manuscript.
Compliance with ethical standards
Drs. Chul Kyu Rho, Hyoung-Il Kim, Jisu Kim, Joong Ho Lee, Minah Cho, Taeil Son, Won Jun Seo, and Woo Jin Hyung have no conflicts of interest or financial ties to disclose.
Supplemental Digital Content 1.mp4: Representative view of intracorporeal delta-shaped gastroduodenostomy using endolinear staplers during reduced-port robotic distal subtotal gastrectomy. (MP4 254934 KB)
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