Reduced-port gastrectomy for gastric cancer with similar port arrangement to conventional five-port laparoscopic gastrectomy

Abstract

In the recent years, approaches such as reduced-port surgery have garnered much attention because of their minimally-invasive nature and improved cosmetic outcomes. Many different types of reduced-port gastrectomy (RPG) for gastric cancer have been reported, and the optimal port size and their arrangement have not yet been established. The authors perform RPG for gastric cancer using an umbilical multi-channel port (MCP) and two needle forceps. In our procedure, a laparoscope and two 5-mm instruments are inserted through umbilical MCP (GelPOINT). The surgeon stands on the patient’s right side and manipulates the conventional laparoscopic instruments through GelPOINT and right upper abdominal wall needle forceps. The first assistant on the patient’s left side uses the forceps inserted through GelPOINT and the left upper abdominal wall needle forceps. Gastrectomy with lymphadenectomy and reconstruction are performed using the same technique as that of conventional five-port laparoscopic gastrectomy (LG). We have successfully used this procedure in over 60 patients with gastric cancer. Our technique for RPG employs the same number of instruments and similar port arrangement as used in conventional five-port LG. This procedure can also achieve almost the same postoperative pain reduction and excellent cosmetic outcomes as observed with single-port gastrectomy.