Fully robotic total gastrectomy with D2 lymphadenectomy for gastric cancer

Robotic surgery with technical advantages was shown to make complex maneuvers easier and more precise for gastric surgery [1]. This video demonstrates our technique on robotic total gastrectomy with the da Vinci Xi platform for gastric cancer. 68-year-old female was presented with persistent epigast...

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Veröffentlicht in:Surgical oncology 2020-03, Vol.32, p.48-48
Hauptverfasser: Benlice, Cigdem, Baca, Bilgi, Hamzaoglu, Ismail, Karahasanoglu, Tayfun
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container_title Surgical oncology
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creator Benlice, Cigdem
Baca, Bilgi
Hamzaoglu, Ismail
Karahasanoglu, Tayfun
description Robotic surgery with technical advantages was shown to make complex maneuvers easier and more precise for gastric surgery [1]. This video demonstrates our technique on robotic total gastrectomy with the da Vinci Xi platform for gastric cancer. 68-year-old female was presented with persistent epigastric abdominal pain and underwent upper endoscopy showed ulcerated mass extended from the cardia to the lesser curvature. Histopathology showed gastric adenocarcinoma. After patient received neoadjuvant chemotherapy, decision was made to proceed with surgery. Initially, greater curvature dissection was started by division of the gastrocolic ligament with entering the lesser sac with monopolar scissors and bipolar forceps. The right gastroomental vessels were identified and divided at their root along with lymph nodes. After ligation of the right gastric vessels, dissection was extended to retrieve lymph nodes around the left gastric vessels. Duodenum was circumferentially dissected and transected 2 cm distal to the pylorus. Subsequently, extended lymphadenectomy was started with suprapancreatic lymph node dissection to retrieve lymph nodes around the common hepatic artery and celiac axis. Spleen-preserving dissection of the lymphatic tissue of the distal splenic artery and the splenic hilum was performed. The distal esophagus was divided with robotic stapler. Fully robotic end-to-side esophagojejunal anastomosis was constructed. For the reconstruction of gastrointestinal continuity after total gastrectomy, side-to-side jejuno-jejunal anastomosis was performed. Total operative time was 5 hours and estimated blood loss was 20 cc. Totally robotic gastrectomy with D2-lymphadenectomy is a safe technique for gastric cancer and provides intracorporeal suturing in reconstructing the anatomy. •This video demonstrates our technique on robotic total gastrectomy with the da Vinci Xi platform for gastric cancer.•Robotic gastrectomy is a safe technique for gastric cancer and provides intracorporeal suturing in reconstructing anatomy.•Robotic surgery with technical advantages was shown to make complex maneuvers easier and more precise for gastric surgery.
doi_str_mv 10.1016/j.suronc.2019.11.001
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source Elsevier ScienceDirect Journals
subjects Adenocarcinoma
Anastomosis
Blood vessels
Cancer
Chemotherapy
Curvature
Cutting tools
Dissection
Duodenum
Endoscopy
Esophagus
Gastrectomy
Gastric cancer
Hepatic artery
Histopathology
Lymph nodes
Maneuvers
Medical instruments
Nodes
Pain
Raw materials
Robotic surgery
Spleen
Splenic artery
Surgery
Total gastrectomy
title Fully robotic total gastrectomy with D2 lymphadenectomy for gastric cancer
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