Abstract:

The gastrocolic ligament was separated from the upper margin of the transverse colon near the central margin of the transverse colon. Left to the colonic splenic flexure, and right to the colonic hepatic flexure. The right gastroepiploic vein and the right gastroepiploic artery were dissected and the lymph node (LN) dissection in the subpyloric region were dissected. Opened the gastropancreatic fold and went into the posterior space of the pancreas from the left side of the suprapancreatic area. Then separated and exposed the initial segment of the splenic artery, and cleaned the No.11pLNs. Naked and cut off the left gastric artery, and cleaned the No.7 and No.9 LNs. Removed the fatty tissues and LNs above the anterior common hepatic artery totally to complete the No.8a LN dissection. Dissected the No.5 and No.12a LNs to the left to complete the suprapancreatic LN dissection. According to the Huang's three-step maneuver, cleaned the LNs of the inferior pole region of spleen, region of splenic trunk and superior pole region of the spleen, respectively. Finally, Roux-en-Y esophagojejunostomy was performed under the 3D laparoscopy.

Key words: Stomach neoplasms, Laparoscopes, Anastomosis, Roux-en-Y