Annals of Surgical Oncology

, Volume 24, Issue 1, pp 184–186 | Cite as

Creation of a Jejunal Pouch During Laparoscopic Total Gastrectomy and Roux-en-Y Esophagojejunostomy

  • Marc A. WardEmail author
  • Michael B. Ujiki
Gastrointestinal Oncology



The creation of Hunt-Lawrence jejunal pouches after total gastrectomy is associated with a better quality of life compared with the standard Roux-en-Y esophagojejunostomy. To the authors’ knowledge, this is the first video to show the technical aspects of creating a jejunal pouch during a laparoscopic total gastrectomy.


A 35-year-old woman was seen for surgical evaluation of a newly diagnosed CDH1 gene mutation. The authors recommended a laparoscopic total gastrectomy with Hunt-Lawrence pouch reconstruction. The jejunal pouch was created using an extracorporeal approach after removal of the stomach. A laparoscopic gel port was then placed over the extraction site to maintain pneumoperitoneum to facilitate a laparoscopic esophagojejunal pouch anastomosis using a circular stapler.


The patient was discharged home on postoperative day 4. Her pathology showed no gastric cancer, and all 31 lymph nodes harvested were free of malignancy. At 1 year postoperatively, she had lost 25 lb from her presurgerical weight and was maintaining a healthy body mass index of 24 kg/m2.


Hunt-Lawerence jejunal pouches have been shown to improve quality of life compared with esophagojejunostomy without pouch formation after total gastrectomy. This video shows a novel technique for jejunal pouch creation during laparoscopic total gastrectomy using a laparoscopic gel port after gastric extraction to facilitate a laparoscopic esophagojejunal pouch anastomosis.


Gastric Cancer Total Gastrectomy Circular Stapler Laparoscopic Total Gastrectomy CDH1 Gene 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



There are no conflicts of interest.

Supplementary material

Supplementary material 1 (MOV 309819 kb)


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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of ChicagoChicagoUSA
  2. 2.Department of SurgeryNorthShore University HealthSystemEvanstonUSA

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