Skip to main content

Laparoscopy assisted distal gastrectomy for T1 to T2 stage gastric cancer: a pilot study of three ports technique

Research Authors
Anwar Tawfik Amin • Adel Gabr • Hamza Abbas
Research Member
Research Department
Research Year
2015
Research Journal
Updates Surg, Italian Society of Surgery (SIC)
Research Publisher
Springer
Research Vol
NULL
Research Rank
1
Research_Pages
NULL
Research Website
NULL
Research Abstract

Abstract Laparoscopy assisted distal gastrectomy (LADG) was first reported in 1994. Since then, it has gradually gained maturity. This procedure is less invasive than conventional open gastrectomy, and the oncologic outcomes are comparable. Recently, single-incision la- paroscopic surgery (SILS) has been developed, which seems to be less invasive than conventional laparoscopic surgery. However, SILS technique is characterized by a limited working area, crowding and crossing of instruments which make it difficult to be applied for oncologic gas- trectomy. In a trial to overcome SILS difficulties, the au- thors report their initial clinical experience of LADG with D1 lymphadenectomy using a novel 3-ports technique. Twenty-one patients have been enrolled for 3-ports la- paroscopic gastrectomy. The patient’s demographic and perioperative data have been collected prospectively. The mean operative time in the first ten cases was 170 min and for the last eleven cases was 140 min (P = 0.01). The mean estimated blood loss was 65 ml. There was no use for additional ports or conversion to open surgery. There were no intra-operative major complications. The mean time for hospital stay was 9 days. One case of pneumonia and one death were the postoperative complications. The mean number of retrieved lymph nodes was 21 and all the cases had free surgical margin. Three-ports LADG with D1 lymphadenectomy could be a safe and oncologically fea- sible procedure; however, a prospective randomized controlled trial comparing three ports LADG with con- ventional multi-ports LADG is required. It is a step towards three-port total laparoscopic distal gastrectomy.