Hand-Assisted Laparoscopic Total Gastrectomy for Early Gastric Cancer

Shinsuke Usui, Haruhiro Inoue, Tatsuya Yoshida, Norio Fukami, Shin Ei Kudo, Takehisa Iwai

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Laparoscopy-assisted distal gastrectomy has been applied to the treatment of early gastric cancer in Japan. However, there have been few reports on the laparoscopy-assisted total gastrectomy mainly because of the difficulty of the procedure. Here, we report a series of cases where hand-assisted laparoscopic total gastrectomies were performed successfully. The mobilization of the greater curvature was performed laparoscopically. About 7-cm mini-laparotomy was made at the epigastrium and duodenal transection was performed with linear stapler. After dissection of suprapyloric and anterosuperior lymph nodes was performed through the mini-laparotomy, dissection of lymph nodes along the celiac artery, and the left gastric artery was performed by hand-assisted laparoscopic surgery. Roux-en-Y reconstruction was performed through the mini-laparotomy. We successfully performed this procedure in 5 patients. The mean operating time and blood loss were 275 minutes and 177.5 mL, respectively. Hand-assisted laparoscopic total gastrectomy is suitable and feasible for early gastric cancer.

Original languageEnglish (US)
Pages (from-to)304-307
Number of pages4
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Issue number5
StatePublished - Oct 2003


  • Gastric cancer
  • Hand-assisted laparoscopic surgery
  • Laparoscopic surgery
  • Mini-laparotomy
  • Roux-en-Y reconstruction
  • Total gastrectomy

ASJC Scopus subject areas

  • Surgery


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