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

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.