Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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V-shaped Liver Retraction during a Laparoscopic Gastrectomy for Gastric Cancer

  • Oh, Dong-Kyo (Department of Surgery, Ajou University, School of Medicine) ;
  • Hur, Hoon (Department of Surgery, Ajou University, School of Medicine) ;
  • Kim, Jun-Young (Department of Surgery, Ajou University, School of Medicine) ;
  • Han, Sang-Uk (Department of Surgery, Ajou University, School of Medicine) ;
  • Cho, Yong-Kwan (Department of Surgery, Ajou University, School of Medicine)
  • Received : 2010.07.13
  • Accepted : 2010.09.02
  • Published : 2010.09.30
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Abstract

Purpose: The aim of this study was to evaluate the effectiveness of our retraction method for achieving a good operative field for the adequate lymph node dissection during laparoscopic gastrectomy in view of short term surgical outcome. Materials and Methods: This study prospectively enrolled 19 patients who underwent laparoscopic gastrectomy for early gastric cancer. The procedure was simply performed by putting the laparoscopic sigle suture in the phrenoesophageal ligament, and then the string was pulling and tying over the sternum. Surgical outcomes of these patients were evaluated. Results: Under V-shaped liver retraction, the mean operating time and mean number of retrieved lymph nodes was 166.3 minute and 31.37, respectively. And the results were satisfactory compared to open or conventional laparoscopic gastric surgery. Conclusions: V-shaped liver retraction requires no extra port or assistant's hands, and prevents additional injury to any intra-abdominal organ. And this method can easily, efficiently and safely enable to achieve a good operative field for the lymph node dissection near the lesser curvature of the stomach.

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References

  1. Adachi Y, Kamakura T, Mori M, Maehara Y, Sugimachi K. Role of lymph node dissection and splenectomy in node-positive gastric carcinoma. Surgery 1994;116:837-841.
  2. de Manzoni G, Verlato G, Guglielmi A, Laterza E, Genna M, Cordiano C. Prognostic signifi cance of lymph node dissection in gastric cancer. Br J Surg 1996; 83:1604-1607. https://doi.org/10.1002/bjs.1800831137
  3. Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004;350:2050-2059. https://doi.org/10.1056/NEJMoa032651
  4. Eltabbakh GH, Shamonki MI, Moody JM, Garafano LL. Laparoscopy as the primary modality for the treatment of women with endometrial carcinoma. Cancer 2001;91:378-387. https://doi.org/10.1002/1097-0142(20010115)91:2<378::AID-CNCR1012>3.0.CO;2-F
  5. Kercher KW, Heniford BT, Matthews BD, Smith TI, Lincourt AE, Hayes DH, et al. Laparoscopic versus open nephrectomy in 210 consecutive patients: outcomes, cost, and changes in practice patterns. Surg Endosc 2003;17:1889-1895. https://doi.org/10.1007/s00464-003-8808-3
  6. Kunisaki C, Shimada H, Nomura M, Akiyama H. Appropriate lymph node dissection for early gastric cancer based on lymph node metastases. Surgery 2001;129:153-157. https://doi.org/10.1067/msy.2001.110222
  7. Hashmonai M, Kopelman D. Sling retraction of the falciform ligament to ameliorate exposure in laparoscopic upper abdominal surgery. Surg Laparosc Endosc 1996;6:71-72. https://doi.org/10.1097/00019509-199602000-00017
  8. Sobin LH, Wittekind C, eds. International Union Against Cancer (UICC) TNM classifi cation of malignant tumors. 5th ed. New York: Wiley-Liss, 1997.
  9. Ryu KW, Lee JH, Choi IJ, Bae JM. Preoperative endoscopic clipping: localizing technique of early gastric cancer. J Surg Oncol 2003;82:75-77. https://doi.org/10.1002/jso.10191
  10. Roviello F, Marrelli D, Morgagni P, de Manzoni G, Di Leo A, Vindigni C, et al. Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of second level lymph nodes: a longitudinal multicenter study. Ann Surg Oncol 2002;9:894-900. https://doi.org/10.1007/BF02557527
  11. Lee JH, Ryu KW, Doh YW, Bae JS, Kim YW, Bae JM. Liver lift: a simple suture technique for liver retraction during laparoscopic gastric surgery. J Surg Oncol 2007;95:83-85. https://doi.org/10.1002/jso.20611
  12. Al-Motabagani, MAH. An anatomical study of the phrenoesophageal ligament. J Anat Soc India 2002;51:18-22.

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