Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Intracorporeal Esophagojejunostomy during Reduced-port Totally Robotic Gastrectomy for Proximal Gastric Cancer: a Novel Application of the Single-Site® Plus 2-port System

  • Choi, Seohee (Department of Surgery, Yonsei University College of Medicine) ;
  • Son, Taeil (Department of Surgery, Yonsei University College of Medicine) ;
  • Song, Jeong Ho (Department of Surgery, Yonsei University College of Medicine) ;
  • Lee, Sejin (Department of Surgery, Yonsei University College of Medicine) ;
  • Cho, Minah (Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Yoo Min (Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Hyoung-Il (Department of Surgery, Yonsei University College of Medicine) ;
  • Hyung, Woo Jin (Department of Surgery, Yonsei University College of Medicine)
  • Received : 2021.01.25
  • Accepted : 2021.05.14
  • Published : 2021.06.30
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Abstract

Purpose: Intracorporeal esophagojejunostomy during reduced-port gastrectomy for proximal gastric cancer is a technically challenging technique. No study has yet reported a robotic technique for anastomosis. Therefore, to address this gap, we describe our reduced-port technique and the short-term outcomes of intracorporeal esophagojejunostomy. Materials and Methods: We conducted a retrospective review of patients who underwent a totally robotic reduced-port total or proximal gastrectomy between August 2016 and March 2020. We used an infra-umbilical Single-Site® port with two additional ports on both sides of the abdomen. To transect the esophagus, a 45-mm endolinear stapler was inserted via the right abdominal port. The common channel of the esophagojejunostomy was created between the apertures in the esophagus and proximal jejunum using a 45-mm linear stapler. The entry hole was closed with a 45-mm linear stapler or robot-sewn continuous suture. All anastomoses were performed without the aid of an assistant or placement of stay sutures. Results: Among the 40 patients, there were no conversions to open, laparoscopic, or conventional 5-port robotic surgery. The median operation time and blood loss were 254 min and 50 mL, respectively. The median number of retrieved lymph nodes was 40.5. The median time to first flatus, soft diet intake, and length of hospital stay were 3, 5, and 7 days, respectively. Three (7.5%) major complications, including two anastomosis-related complications and a case of small bowel obstruction, were treated with an endoscopic procedure and re-operation, respectively. No mortality occurred during the study period. Conclusions: Intracorporeal esophagojejunostomy during reduced-port gastrectomy can be safely performed and is feasible with acceptable surgical outcomes.

Keywords

Acknowledgement

We would like to thank Editage (www.editage.co.kr) for English language editing.

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