Robotic digestive tract reconstruction after total gastrectomy for gastric cancer: a simple way to do it
| Autor: | Carlos Eduardo Jacob, Guilherme Tommasi Kappaz, Edison Dias Rodrigues Filho, Leandro Cardoso Barchi, Bruno Zilberstein, Maurice Franciss |
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| Rok vydání: | 2015 |
| Předmět: |
Laparoscopic surgery
Gastrointestinal tract medicine.medical_specialty business.industry Stomach medicine.medical_treatment Splenectomy Biophysics Robotic Surgical Procedures 030230 surgery Anastomosis Computer Science Applications Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis medicine Gastrectomy Esophagus business |
| Zdroj: | The International Journal of Medical Robotics and Computer Assisted Surgery. 12:598-603 |
| ISSN: | 1478-5951 |
| DOI: | 10.1002/rcs.1720 |
| Popis: | Background Intracorporeal digestive tract reconstruction after minimally invasive total gastrectomy may be challenging, even when using the da Vinci® Surgical System. This may be due to intrinsic difficulties during oesophago–jejunal anastomosis (EJA). The aim of this study was to describe a simple way to perform digestive tract reconstruction after robotic total gastrectomy (RTG) for gastric cancer and the results of its application in a small series of cases. Methods In the last 2 years, six patients with gastric adenocarcinoma have been treated by RTG, four male and two female, with mean age of 59.8 (range 48–74) years. The tumour was located in the gastric body in three patients, the gastric antrum in two patients and the fundus in one patient with no need of splenectomy. In all cases, D2 lymphadenectomy was completed. A modified robotic reconstruction technique proposed by the authors was used in these operations, which consists in a latero–lateral EJA using a linear stapler. An entero–enterostomy is also performed in the upper abdomen. Results The mean operative time was 408 (range 340–481) min. The mean time for digestive tract reconstruction was 57 (range 47–68) min. There were no conversions to open or laparoscopic surgery. The number of lymph nodes removed varied in the range 28–52 (average 40). There was no mortality. Postoperative staging showed three T1N0M0s, one T2N0M0, one T3N0M0 and one T3N2M0. Conclusion This series, which despite being small, demonstrates that this robotic reconstruction technique is safe, with no major complications, demands a relatively short time for its accomplishment, even when dealing with initial experience. Copyright © 2015 John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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