Abstract:

The liver was suspended to expose the surgical field clearly. The greater omentum attached to the transverse colon was cut from middle to left until No.2 short gastric vessels. The left gastroepiploic vessels were isolated and cut off, and No.4sb lymph nodes were removed. Next, the dissection was continued rightward to the hepatic flexure to completely separate greater omentum and colon. Exposing the pancreatic head and duodenal bulb, the right gastroepiploic vessels were ligated. No.4d and No.6 lymph nodes were dissected. Then the pancreatic membrane was detached from right to left and bottom to up. Upper margin of the pancreas was exposed and the common hepatic artery was freed for the removal of No.8a and No.12a lymph nodes. Subsequently, the left gastric vessels were ligated, and the dissection was performed along the splenic artery to the left until the posterior gastric artery. No.7, No.9 and No.11 lymph nodes were dissected. Dissecting the region of lesser curvature and cutting the hepatogastric ligament, No.5 and No.12a lymph nodes were removed right after the ligation of right gastric vessels. After that, right phrenic angle and esophageal hiatus was exposed to dissect No.1 and No.3 lymph nodes. Finally, Billroth II anastomosis was performed by using liner stapler, and the common opening was stitched with barbed thread.

Key words: Stomach neoplasms, Laparoscopes, Gastrectomy, Lymph node excision