Intracorporeal overlap gastro-gastrostomy for solo single-incision pylorus-preserving gastrectomy in early gastric cancer
This report discusses the technique of solo single-incision pylorus-preserving gastrectomy (SIPPG) for early gastric cancer. To overcome difficulties regarding lymph node dissection (LND), a scope holder and an energy device were used, allowing fine dissection in a fixed field of view. The overlap gastro-gastrostomy technique was used for anastomosis. Seventeen patients underwent solo SIPGG. The mean operation time was 150.1 ± 28.7 min, and no patients developed postoperative complications or delayed gastric emptying within 30 days of the operation. Using scope holders and performing fine dissection with the energy device, challenges regarding LND in SIPPG can be overcome. INTACT anastomosis was initially used; however, due to its inconsistency and the high degree of surgical skill required, it was changed to the overlap method. Solo SIPPG with overlap gastro-gastrostomy may be safe and feasible with good cosmetic results and fast patient recovery.
KeywordsStomach Stomach neoplasm Laparoscopic surgery
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest in association with the present study.
- 11.Kang SH, Cho Y-S, Min S-H, Park YS, Ahn S-H, Park DJ, et al. Early experience and learning curve of solo single-incision distal gastrectomy for gastric cancer: a review of consecutive 100 cases. Surg Endosc. 2019;23:896.Google Scholar
- 14.Irino T. The Hit and Away technique: optimal usage of the ultrasonic scalpel in laparoscopic gastrectomy. Surg Endosc. 2015;30:1–6.Google Scholar
- 16.Inaba K, Satoh S, Ishida Y, Taniguchi K, Isogaki J, Kanaya S, et al. Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. JACS. 2010;211:e25–e2929.Google Scholar
- 20.Schmidt B, Chang KK, Maduekwe UN, Look-Hong N, Rattner DW, Lauwers GY, et al. D2 lymphadenectomy with surgical ex vivo dissection into node stations for gastric adenocarcinoma can be performed safely in Western patients and ensures optimal staging. Ann Surg Oncol. 2013;20:2991–9.CrossRefGoogle Scholar
- 31.Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, et al. Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc. 2010;24:1842–8.CrossRefGoogle Scholar