Reconstruction for Esophagojejunostomy
Although esophagojejunostomy is the most important step in laparoscopic total gastrectomy, it is still mired in controversy with no existing standard protocol. The first point of contention is the time of esophageal transection. There are two alternatives: before dissection of lymph node stations 11d and 10 or after completing the dissection of the lymph nodes around the splenic hilum. We prefer the former because it enables wider exposure of the splenic hilum, thus making the subsequent nodal dissection of station 10 safer.
KeywordsCircular Stapler Splenic Hilum Laparoscopic Total Gastrectomy Orogastric Tube Intracorporeal Anastomosis