当科における腹腔鏡補助下幽門側胃切除Roux-en-Y吻合の手技

Abstract

The recent technical advancement of laparoscopic surgery enables us to perfo㎜ variant laparoscopic operations. The Roux-en-Y reconstruction for gastrectomy is also practicable laparoscopically. However, the generally developed method of laparoscopic Roux-en-Y reconstruction is complicated and costly because of multiple uses of auto-suturing instruments, so the method has not become widely used. We perform laparoscope assisted distal gastrectomy reconstructed by Billroth-I anastomosis (LADG-BI) for patients who are diagnosed with early gastric cancer impossible to undergo endoscopic resection (EMR), but in case of a lesion in the middle or upper gastric body, we need to reconstrusts by Roux-en-Y anastomosis (LADG-RY). With our devise, in LADG-RY, all anastomotic procedures are operable outside of the abdominal cavity and use of the auto-suturing instrument is reqaired only twice. Our device enablles us to perform LADG-RY without the problems described above. No differences are seen in operation time, bleeding, and curability between our LADG-RY and laparotomic Roux-en-Y reconstruction.