A procedure for laparoscopy-assisted proximal gastrectomy

A new surgical technique for treatment of early gastric cancer and large su bmucosal tumor located in cardia, laparoscopy-assisted proximal gastrectomy with regional lymphadenectomy, is described and its use in Six patients on reported. Grater curvature side and lesser curvature side of the proximal gastric wall was dissected with DI regional lymph node, using a thinner Har monic scalpel LCS. The origin of left gastroepiploic or left gastric vessel s were identified, clipped and divided. D2 lymphadenectomy around the celia c axis, along the splenic and left gastric arteries, and around the splenic hylus were also completed. After mobilized around the proximal stomach, sm all incision was made to transect a 1/3 to 2/3 of proximal stomach with lym ph node and to create reconstruction and pyloroplasty. Using a small Kent r etractor, abdominal sliding method via a small abdominal window, was facili tate safe and rapid proximal gastrectomy and reconstruction. Reconstruction was made by jejunal loop interposition in 3 patients, and residual gastric tube in 3 patients. These patients were obtained quicker recovery and good quality of life.