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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2022, Vol. 16 ›› Issue (03): 256-256. doi: 10.3877/cma.j.issn.1674-3946.2022.03.006

Special Issue:

• Operation Theater • Previous Articles     Next Articles

Total laparoscopic radical distal gastrectomy

Jingtao Wei1, Xin Ji1,()   

  1. 1. Department of Gastrointestinal Cancer Center,Peking University Cancer Hospital and Institute,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Beijing 100142,China
  • Online:2022-04-26 Published:2022-05-16
  • Contact: Xin Ji

Abstract:

After loosening the adhesions,dissect the gastrocolic ligament,the right side to the hepatic flexure of the colon. Under the pylorus,isolate and cut the right gastroepiploic vessel,and dissect the No. 6 lymph nodes. Expose the hepatoduodenal ligament and remove the No.12a lymph nodes. Open the lesser omentum up to the right side of the cardia. Ligate and dissect the right gastric vessel and dissect the No.5 lymph nodes. Fully isolate and dissect the duodenum. Seek the common hepatic artery along the gastroduodenal artery and remove group No.8a lymph nodes. At the superior margin of the pancreas,the No.11p lymph nodes were cleared along the splenic artery. Separate and cut the left gastric vessels to complete the No.7 and No.9 lymph node dissection. The lymph nodes of No.1 and No.3 were dissected along the anterior and posterior walls of the gastric minor curvature from the middle of the gastric body to the cephalad and right side,respectively. Uncover and cut the left gastroepiploic vessel,remove the lymph nodes at its root,and expose the gastric wall of the greater curvature to remove the No.4sb and No.4d lymph nodes,and then complete the D2 lymph node dissection. Reconstruction of the digestive tract was performed by Billroth anastomosis + Braun anastomosis.

Key words: Stomach neoplasms, Totally laparoscopic surgery, D2 lymphadenectomy

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