Intracorporeal Reconstruction in Laparoscopic Gastrectomy

Abstract

Laparoscopic gastrectomy is a widely used minimally invasive technique for the treatment of gastric cancer. Since the introduction of extracorporeal reconstruction through a minilaparotomy in laparoscopy-assisted gastrectomy, efforts have been made to establish techniques for intracorporeal reconstruction in both laparoscopic distal gastrectomy (LDG) and laparoscopic total gastrectomy (LTG). In LDG, linear staplers are preferable to circular staplers for the creation of the gastroduodenostomy or gastrojejunostomy, and both linear and circular staplers have a role in LTG. These techniques have had acceptable surgical outcomes as described in the literature. We use linear staplers for reconstruction with the advantage of easier handling in a limited space and a better operative view during the anastomosis. In this chapter, technical tips and pitfalls of intracorporeal reconstruction in LDG and LTG are reported. The reconstruction-related short-term outcomes in our institution are described.