A Simple Method of Intracorporeal "w-shaped" Liver Retraction Technique for Minimally Invasive Gastric Cancer Surgery

研究成果: Article

摘要

Minimally invasive gastric cancer surgery requires an extended liver retraction in order to provide optimal operative view, working space for lymph node dissection, and esophageojejunal reconstruction. Ideally, it should avoid reposition of the retractor, additional skin incision or puncture, and liver parenchyma injury. Herein, we introduced an intracorporeal W-shaped liver retraction technique (W-LRT) for minimally invasive gastric cancer surgery without an additional incision or abodminal puncture.Methods:Between October 2013 and October 2016, the W-LRT was applied in 80 patients undergoing minimally invasive gastric cancer surgery. The W-LRT was performed using one 75 cm 3-0 monocryl suture with its end fixed to one hemoclip. The perioperative outcome was recorded.Results:The W-LRT was applied in 80 gastric cancer patients using either laparoscopic approach (N=69) or robotic approach (N=11). The mean age was 62.7±14 years and the mean body mass index (BMI) was 24.1±3.6 kg/m2. The time required for W-LRT was 5.6±5.2 minutes in laparoscopic approach and 6.2±4.7 minutes in robotic approach. This technique was successfully applied in all procedures and no other technique or additional instrument was required. Major complications developed in 7 patients (8.8%), classified as greater than Clavien-Dindo classification II; however, there was neither any intraoperative nor postoperative major complication related to W-LRT. The length of hospital stay was 9.1±4.4 days.Conclusions:In laparoscopic or robotic gastric cancer surgery, the W-LRT can provide excellent operative view during lymph node dissection and reconstruction of esophagojejunostomy and eliminate an additional skin incision or abdominal puncture.

原文English
頁(從 - 到)E24-E28
期刊Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
29
發行號3
DOIs
出版狀態Published - 2019 六月 1

指紋

Stomach Neoplasms
Liver
Robotics
Punctures
Lymph Node Excision
Length of Stay
Skin
Sutures
Body Mass Index
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery

引用此文

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title = "A Simple Method of Intracorporeal {"}w-shaped{"} Liver Retraction Technique for Minimally Invasive Gastric Cancer Surgery",
abstract = "Minimally invasive gastric cancer surgery requires an extended liver retraction in order to provide optimal operative view, working space for lymph node dissection, and esophageojejunal reconstruction. Ideally, it should avoid reposition of the retractor, additional skin incision or puncture, and liver parenchyma injury. Herein, we introduced an intracorporeal W-shaped liver retraction technique (W-LRT) for minimally invasive gastric cancer surgery without an additional incision or abodminal puncture.Methods:Between October 2013 and October 2016, the W-LRT was applied in 80 patients undergoing minimally invasive gastric cancer surgery. The W-LRT was performed using one 75 cm 3-0 monocryl suture with its end fixed to one hemoclip. The perioperative outcome was recorded.Results:The W-LRT was applied in 80 gastric cancer patients using either laparoscopic approach (N=69) or robotic approach (N=11). The mean age was 62.7±14 years and the mean body mass index (BMI) was 24.1±3.6 kg/m2. The time required for W-LRT was 5.6±5.2 minutes in laparoscopic approach and 6.2±4.7 minutes in robotic approach. This technique was successfully applied in all procedures and no other technique or additional instrument was required. Major complications developed in 7 patients (8.8{\%}), classified as greater than Clavien-Dindo classification II; however, there was neither any intraoperative nor postoperative major complication related to W-LRT. The length of hospital stay was 9.1±4.4 days.Conclusions:In laparoscopic or robotic gastric cancer surgery, the W-LRT can provide excellent operative view during lymph node dissection and reconstruction of esophagojejunostomy and eliminate an additional skin incision or abdominal puncture.",
author = "Chih-Jung Wang and Ying-Jui Chao and Shih, {Chun Wei} and Yan-Shen Shan",
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T1 - A Simple Method of Intracorporeal "w-shaped" Liver Retraction Technique for Minimally Invasive Gastric Cancer Surgery

AU - Wang, Chih-Jung

AU - Chao, Ying-Jui

AU - Shih, Chun Wei

AU - Shan, Yan-Shen

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Minimally invasive gastric cancer surgery requires an extended liver retraction in order to provide optimal operative view, working space for lymph node dissection, and esophageojejunal reconstruction. Ideally, it should avoid reposition of the retractor, additional skin incision or puncture, and liver parenchyma injury. Herein, we introduced an intracorporeal W-shaped liver retraction technique (W-LRT) for minimally invasive gastric cancer surgery without an additional incision or abodminal puncture.Methods:Between October 2013 and October 2016, the W-LRT was applied in 80 patients undergoing minimally invasive gastric cancer surgery. The W-LRT was performed using one 75 cm 3-0 monocryl suture with its end fixed to one hemoclip. The perioperative outcome was recorded.Results:The W-LRT was applied in 80 gastric cancer patients using either laparoscopic approach (N=69) or robotic approach (N=11). The mean age was 62.7±14 years and the mean body mass index (BMI) was 24.1±3.6 kg/m2. The time required for W-LRT was 5.6±5.2 minutes in laparoscopic approach and 6.2±4.7 minutes in robotic approach. This technique was successfully applied in all procedures and no other technique or additional instrument was required. Major complications developed in 7 patients (8.8%), classified as greater than Clavien-Dindo classification II; however, there was neither any intraoperative nor postoperative major complication related to W-LRT. The length of hospital stay was 9.1±4.4 days.Conclusions:In laparoscopic or robotic gastric cancer surgery, the W-LRT can provide excellent operative view during lymph node dissection and reconstruction of esophagojejunostomy and eliminate an additional skin incision or abdominal puncture.

AB - Minimally invasive gastric cancer surgery requires an extended liver retraction in order to provide optimal operative view, working space for lymph node dissection, and esophageojejunal reconstruction. Ideally, it should avoid reposition of the retractor, additional skin incision or puncture, and liver parenchyma injury. Herein, we introduced an intracorporeal W-shaped liver retraction technique (W-LRT) for minimally invasive gastric cancer surgery without an additional incision or abodminal puncture.Methods:Between October 2013 and October 2016, the W-LRT was applied in 80 patients undergoing minimally invasive gastric cancer surgery. The W-LRT was performed using one 75 cm 3-0 monocryl suture with its end fixed to one hemoclip. The perioperative outcome was recorded.Results:The W-LRT was applied in 80 gastric cancer patients using either laparoscopic approach (N=69) or robotic approach (N=11). The mean age was 62.7±14 years and the mean body mass index (BMI) was 24.1±3.6 kg/m2. The time required for W-LRT was 5.6±5.2 minutes in laparoscopic approach and 6.2±4.7 minutes in robotic approach. This technique was successfully applied in all procedures and no other technique or additional instrument was required. Major complications developed in 7 patients (8.8%), classified as greater than Clavien-Dindo classification II; however, there was neither any intraoperative nor postoperative major complication related to W-LRT. The length of hospital stay was 9.1±4.4 days.Conclusions:In laparoscopic or robotic gastric cancer surgery, the W-LRT can provide excellent operative view during lymph node dissection and reconstruction of esophagojejunostomy and eliminate an additional skin incision or abdominal puncture.

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