Hand-assisted laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer

Recently, a minimally invasive operation for gastric malignancies has been advocated, and the laparoscopic operation is noted as a technique that rais es the quality of life. We performed distal gastrectomy with regional lymph node dissection by hand-assisted laparoscopic surgery for 60 cases of gast ric cancer located in the middle or lower third of the stomach. Billroth I reconstruction was applied intracorporeally to the first 30 cases by using the double stapling method with a conventional circular stapling device, an d in the final 30 cases, the quadrilateral (square) stapling technique with a laparoscopic linear stapling device was used to prevent postoperative an astomotic bleeding. This technique not only is less invasive, but also is s imilarly curative compared with open gastrectomy that was performed for 60 gastric cancer cases of similar staging before the beginning of this proced ure.