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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2026, Vol. 20 ›› Issue (02): 116-116. doi: 10.3877/cma.j.issn.1674-3946.2026.02.005

• Operation Theater • Previous Articles    

Reduced-port laparoscopic surgery with assistant-free (RPLS-AF) for esophagogastric junction cancer of Siewert type II

Su Yan(), Kang Zhao, Hongyu Xie, Bowen Huo, Hao Liang, Yuanyuan Li, Yunrong Li   

  1. Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining Qinghai Province 810001, China
  • Online:2026-04-26 Published:2026-01-26
  • Contact: Su Yan
  • Supported by:
    Noncommunicable Chronic Diseases-National Science and Technology Major Project(2025ZD0551504)

Abstract:

In cases of Siewert type II esophagogastric junction cancer with esophageal invasion measuring less than 2 cm, the transhiatal approach facilitates the performance of lower mediastinal lymphadenectomy in conjunction with D2 perigastric lymph node dissection. We present the inaugural instances of reduced-port laparoscopic surgery conducted without an assistant for Siewert type II esophagogastric junction cancer. The diaphragmatic esophageal fascia was initially incised along the attachment of the dorsal mesogastrium. Subsequently, the right infracardiac bursa was meticulously dissected into the dorsal side of the mesoesophagus, exposed, and incised. By mobilizing the infracardiac bursa cranially, the No.110 and No.112 lymph node groups, along with the periesophageal adipose tissue, were systematically dissected en bloc, thereby completing the lower mediastinal lymph node dissection. The surgical procedure commenced with the mobilization of the greater omentum from its attachment to the transverse colon. Upon reaching the infra-pyloric region, the right gastroepiploic ligament was retracted with care, allowing for meticulous dissection along its root to enable en bloc removal. A comprehensive lymph node dissection was then conducted in the infra-pyloric and supra-pancreatic regions, as well as the No.4sb group, facilitating communication with the lower mediastinum. Subsequently, the surgeon independently performed a side-to-side jejunojejunostomy and esophagojejunostomy utilizing the overlap technique.

Key words: Esophagogastric Junction Carcinoma, Assistant-Free, Reduced-Port Laparoscopy

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