Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy

Surg Endosc. 2011 Apr;25(4):1300-5. doi: 10.1007/s00464-010-1367-5. Epub 2010 Oct 17.

Abstract

Background: Laparoscopy-assisted total gastrectomy (LATG) is not a commonly performed procedure due to the surgical difficulty associated with reconstruction. Although various reconstruction methods have been reported, a standard technique has not yet been established. In this study, we compared the short-term outcomes of LATG reconstructed by mini-laparotomy and by the newly developed transorally inserted anvil (OrVil).

Methods: From April 2006, a series of 45 patients underwent LATG. Of these, 15 were reconstructed by mini-laparotomy and 30 by OrVil. Short-term outcomes were compared between the two groups.

Results: Operation time was significantly shortened and intraoperative blood loss significantly reduced by the use of OrVil. The postoperative course, including morbidity, did not differ between the two groups.

Conclusions: LATG using OrVil for the treatment of early gastric cancer is a technically feasible surgical procedure with sufficient lymph node dissection, satisfactory early recovery, and acceptable morbidity. It will be necessary to perform this novel technique in a large number of patients to confirm its feasibility.

Publication types

  • Clinical Trial

MeSH terms

  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Roux-en-Y / instrumentation*
  • Blood Loss, Surgical / prevention & control
  • Equipment Design
  • Esophagus / surgery
  • Female
  • Gastrectomy / methods*
  • Humans
  • Intra-Abdominal Fat / pathology
  • Jejunum / surgery
  • Laparoscopy / methods*
  • Laparotomy / methods*
  • Length of Stay / statistics & numerical data
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Mouth
  • Postoperative Complications / epidemiology
  • Stomach Neoplasms / surgery*
  • Surgical Stapling / instrumentation*
  • Treatment Outcome