tailieunhanh - báo cáo khoa học: "Reconstruction of the esophagojejunostomy by double stapling method using EEA™ OrVil™ in laparoscopic total gastrectomy and proximal gastrectomy"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Reconstruction of the esophagojejunostomy by double stapling method using EEA™ OrVil™ in laparoscopic total gastrectomy and proximal gastrectomy | Hirahara et al. World Journal of Surgical Oncology 2011 9 55 http content 9 1 55 WORLD JOURNAL OF SURGICAL ONCOLOGY TECHNICAL INNOVATIONS Open Access Reconstruction of the esophagojejunostomy by double stapling method using EEA OrVil in laparoscopic total gastrectomy and proximal gastrectomy Noriyuki Hirahara Hiroyuki Monma Yoshihide Shimojo Takeshi Matsubara Ryoji Hyakudomi Seiji Yano and Tsuneo Tanaka Abstract Here we report the method of anastomosis based on double stapling technique hereinafter DST using a transoral anvil delivery system EEATM OrVilTM for reconstructing the esophagus and lifted jejunum following laparoscopic total gastrectomy or proximal gastric resection. As a basic technique laparoscopic total gastrectomy employed Roux-en-Y reconstruction laparoscopic proximal gastrectomy employed double tract reconstruction and end-to-side anastomosis was used for the cut-off stump of the esophagus and lifted jejunum. We used EEATM OrVilTM as a device that permitted mechanical purse-string suture similarly to conventional EEA and endo-Surgitie. After the gastric lymph node dissection the esophagus was cut off using an automated stapler. EEATM OrVilTM was orally and slowly inserted from the valve tip and a small hole was created at the tip of the obliquely cut-off stump with scissors to let the valve tip pass through. Yarn was cut to disconnect the anvil from a tube and the anvil head was retained in the esophagus. The end-Surgitie was inserted at the right subcostal margin and after the looped-shaped thread was wrapped around the esophageal stump opening assisting Maryland forceps inserted at the left subcostal and left abdomen were used to grasp the left and right esophageal stump. The surgeon inserted anvil grasping forceps into the right abdomen and after grasping the esophagus with the forceps tightened the end Surgitie thereby completing the purse-string suture on the esophageal stump. The main unit of the automated stapler was inserted .