Abstract:

After general anesthesia, established pneumoperitoneum with 5-hole method. Exploration: no ascites, no serosa invasion of the stomach, perigastric lymph nodes slightly swollen, no peritoneal metastasis. Complete laparoscopic radical distal gastrectomy (D2 lymph node dissection, Billroth II with Braun anastomosis) was performed. Surgical route: opened the hepatogastric ligament, and the right side of cardia along the surface of the right diaphragmatic angle; opened the gastrocolic ligament, entered the fusion space, cutted the right gastro-omental vessels, cleaning No. 6 lymph nodes; After dissection of duodenum, cleaned the lymph nodes above pancreas, successively: No. 5, 12a, 8a, 11p, 7, 9; then No.1, 3, 4sb, 4d; And then cutted off distal stomach, the specimen was taken out from a 3.5cm incision around the umbilicus; Took the jejunum 40cm from the Treize's ligament, and the remnant stomach to do side to side anastomosis (BiIIroth II anastomosis), then did side to side anastomosis (Braun anastomosis) between afferent loop and output loops, 25cm away from the Billroth II anastomosis. All procedures were done laparoscopically.

Key words: Stomach neoplasms, Laparoscopes, Radical gastrectomy, Braun anastomosis